The Effects of Lidocaine, Fentanyl, Nicardipine, and Esmolol on Hemodynamic and Bispectral Index Responses during Induction with Thiopental Sodium

Abstract

Background: The laryngoscopy and tracheal intubation may accompany with undesirable side effects such as hypertension, tachycardia, arrhythmia, and awareness. The aim of this study was to investigate whether the correlation between the hemodynamics and bispectral index (BIS) changes after tracheal intubation following the administration of various adjuvants to attenuate tracheal response exists or not. Methods: The patients were randomly assigned to one of five groups (control, lidocaine, fentanyl, nicardipine, or esmolol) and the drugs were administered at preselected time before tracheal intubation. The heart rate (HR), blood pressure, rate-pressure product (RPP), BIS and the episode of BIS more than 65 (BIS ≥ 65) were measured. Results: There were significant differences in the mean arterial pressure and RPP between control group and other groups. The HR was the most attenuated in esmolol group. The HR and RPP was the most increased in nicardipine group except control group. There was no significant difference in the maximal BIS among the five groups. The BIS ≥ 65 were 50% in control group and 0.3% in nicardipine group. Conclusions: All the adjuvant drugs in the study attenuated with a various degree of the tracheal responses. However, there was no correlation between the changes of hemodynamics and BIS after the administration of various adjuvants following tracheal intubation.

A Comparative Study between Intravenous Fentanyl and Intravenous Lidocaine on Attenuation of Hemodynamic Pressor Responses to Laryngoscopic Intubation: A Prospective Cohort Study, Ethiopia

“…Also, a study was done in Korea (2007) showed that the heart rate was significantly lower in fentanyl group compared to lidocaine group at first, second and third minute after intubation (p > 0.05) [14]. Same results were reported in another study [15].…”

The Effectiveness of Esmolol in Attenuating the Arousal Response (Heamodynamic Changes and Bis Index) to Endotracheal Intubation in Patients Undergoing Surgical Procedures

“…The observations are consistent with the findings of by Jiang Yong, et al [22] who reported that a single dose of esmolol 1mg/ Kg better attenuate diastolic blood pressure than 0.5 mg/kg given before intubation. Shin, et al [25] also noted a significant fall in mean diastolic blood pressure compared to baseline values at all the measurement times (Table 8).…”

“…Journal of Anesthesia & Intensive Care Medicine systolic blood pressure than 0.5 mg/kg given before intubation. Shin H Y, et al [25] observed that there were significant differences in the mean arterial pressure between control group and other groups (Table 7).…”

Fentanyl and fentanyl plus lidocaine on attenuation of haemodynamic stress response to laryngoscopy: a comparative study in controlled hypertensive patients posted for laparoscopic cholecystectomy

“…that compared the effects of lidocaine, fentanyl, Nicardipine and Esmolol, on the hemodynamic response during intubation and those studies showed that all the agents are effective in producing hemodynamic stability. 27 According to Levitt et al Esmolol and lidocaine have similar efficacies to attenuate moderate hemodynamic responses to intubation in patients with isolated head trauma. 28 Additionally, Malde and Sarode in a 2007 study compared lignocaine and fentanyl efficacy on hemodynamic stability and revealed that lignocaine and fentanyl both attenuated the rise in heart rate, however, fentanyl produced better results.…”