Attenuation of Cardiovascular Responses and Upper Airway Events to Tracheal Extubation by Low Dose Propofol

Vaziri, M T Moein; Jouybar, Reza; Vaziri, Nader Moein; Vaziri, Najmeh Moein; Panah, Ashkan

doi:10.5812/ircmj.1846

Cited by 6 publications

(1 citation statement)

References 12 publications

(11 reference statements)

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“…Propofol 0.5 mg/kg reduces the systolic blood pressure by reducing systemic vascular resistance, cardiac contractility, preload, sympathetic inhibition, while lidocaine 1.5 mg/kg reduced the systolic blood pressure by central stimulation effect, peripheral vasodilator, suppressing the airway reflexes [ 22 , 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Lidocaine versus propofol administration on the attenuation of hemodynamic responses during extubation in the adult elective surgical patient: A prospective cohort

Nigussie

Aregawi

Abrar

et al. 2021

Heliyon

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Background Tracheal extubation is the process of removing a tube from the trachea. It is associated with an increase in heart rate, blood pressure, intracranial pressure, intraocular pressure, coughing, bronchospasm, laryngospasm, and bleeding. Many techniques, as well as drugs, have been attempted for attenuation of the airway and cardiovascular responses. Propofol and lidocaine are widely available drugs in resource-limited settings even though their relative effectiveness for smooth extubation is not well established. Objectives To assess the effectiveness of intravenous lidocaine and propofol on the attenuation of extubation-induced hemodynamic responses in the adult elective surgical patient from November 01, 2019, to February 30, 2020, at Asella teaching and referral hospital, Ethiopia. Methods Institutional-based prospective observational cohort study design was conducted on 72 ASA I patients who underwent elective surgery. The study participants were allocated into three groups equally based on anesthetists' extubation plan; Group P, 0.5 mg/kg propofol, group L, 1.5 mg/kg lidocaine administered 2 min before extubation and group C was a control group. Data were analyzed by SPSS version 20 after the normality of the data was checked by the Shapiro Wilk test. One-way ANOVA followed by a Tukey posthoc test has been employed to find the pair-wise significance and a p-value of <0.05 was considered as statistically significant. Results A demographic status and clinical characteristics of the patient were comparable between groups with p-values of >0.05. After extubation; heart rate, systolic, diastolic, and mean arterial blood pressure were decreased significantly in groups of propofol and lidocaine within 10 min. Propofol shows better results in maintaining stable systolic blood pressure up to 3 min, while heart rate, diastolic, and mean arterial pressure were maintained stable up to 5 min after extubation (p = 0.001). Conclusions 0.5 mg/kg propofol or 1.5 mg/kg lidocaine might help to attenuate extubation induced hemodynamic responses.

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Section: Discussionmentioning

confidence: 99%

Lidocaine versus propofol administration on the attenuation of hemodynamic responses during extubation in the adult elective surgical patient: A prospective cohort

Nigussie

Aregawi

Abrar

et al. 2021

Heliyon

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Replacing a double-lumen tube with a single-lumen tube or a laryngeal mask airway device to reduce coughing at emergence after thoracic surgery: a randomized controlled single-blind trial

Tanoubi

Sun

Drolet

et al. 2015

Can J Anesth/J Can Anesth

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Replacing a double-lumen tube with a single-lumen tube or a laryngeal mask airway device to reduce coughing at emergence after thoracic surgery: a randomized controlled single-blind trial Remplacement de la sonde double lumière par une sonde à une seule lumière ou un masque laryngé pour réduire la toux lors du réveil suivant une chirurgie thoracique: une étude randomisée contrôlée en simple aveugle Abstract Background Coughing episodes occur frequently at extubation after thoracic surgery, and this may be due in part to the double-lumen tube (DLT). In this study, the DLT was replaced with either a single-lumen endotracheal tube (ETT) or a laryngeal mask airway (LMA) device or left in place, and the incidence of coughing at emergence was compared between the three groups. Methods Fifty-eight adults scheduled for thoracic surgery with a DLT were included. Exclusion criteria were an anticipated difficult airway, obesity, and contraindication to the use of an LMA ProSeal TM (LMA-P). After surgery but before emergence, patients were randomized to having the DLT (1) removed and replaced by an LMA-P (LMA-P Group), (2) removed and replaced by an ETT (ETT Group), or (3) left in place (DLT Group). The primary outcome was the number of coughing episodes at extubation. Results Among 184 patients screened, 124 did not meet inclusion criteria, and two patients, both in the ETT Group, were excluded after randomization, leaving 20, 18, and 20 patients in the LMA-P, ETT, and DLT Groups, respectively. There were fewer coughing episodes (median [quartiles]) in the LMA-P Group than in the DLT Group (0[0-1] vs 2 [1-3], respectively; P = 0.01). In the DLT Group, 90% of patients coughed at least once. This incidence was not significantly different in the ETT Group (83%; P = 0.222) but was significantly reduced in the LMA-P Group (35%; P \ 0.001). No patient had oxygen desaturation during airway exchange or at extubation. The incidence and severity of hoarseness and sore throat were similar in all groups. Conclusion Coughing at extubation after thoracic surgery can be reduced if the DLT is replaced by an LMA-P before emergence. The number of patients in this trial was too small to evaluate the risks associated with exchanging the airway device. This trial was registered at ClinicalTrials.gov: NCT00925613. RésuméContexte Les épisodes de toux surviennent fréquemment lors de l'extubation après une chirurgie thoracique, et ils pourraient être provoqués en partie par la sonde double This study was performed at the Department of Anesthesiology, Hôpital Maisonneuve Rosemont, a Université de Montréal affiliated centre.

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Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial

Elokda

ELShamaa

2015

Egyptian Journal of Anaesthesia

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Attenuation of Cardiovascular Responses and Upper Airway Events to Tracheal Extubation by Low Dose Propofol

Cited by 6 publications

References 12 publications

Lidocaine versus propofol administration on the attenuation of hemodynamic responses during extubation in the adult elective surgical patient: A prospective cohort

Lidocaine versus propofol administration on the attenuation of hemodynamic responses during extubation in the adult elective surgical patient: A prospective cohort

Replacing a double-lumen tube with a single-lumen tube or a laryngeal mask airway device to reduce coughing at emergence after thoracic surgery: a randomized controlled single-blind trial

Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial

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