Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively

S. Singh; Kulsum; H. Shroff; A. Singh; A. Annamalai; D. E. Mahrous

doi:doi:10.11648/j.ja.20130103.13

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Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively

S. Singh, Kulsum, H. Shroff, A. Singh, A. Annamalai, D. E. Mahrous

Published in Journal of Anesthesiology (Volume 1, Issue 3)

Received: 16 September 2013 Published: 20 December 2013

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Abstract

Background: Tachycardia and hypertension are well documented sequels of laryngoscopy and endotracheal intubation; they are transient, highly variable and are generally well tolerated in healthy patients. In hypertensive patients with coronary artery disease (CAD) these cardiovascular responses to laryngoscopy and intubation is exaggerated. The aim of this study was to evaluate the efficacy of lidocaine in attenuating cardiovascular response to laryngoscopy and endotracheal intubation in patients posted for elective off pump coronary artery bypass grafting (OPCABG) as these patients are on a low dose of ß-blockers. Materials and Methods: After obtaining institutional ethical approval, 60 patients aged 40 to 70 years from either sex of the American Society of Anaesthesiologists (ASA) physical status III with coronary artery disease (CAD) undergoing elective coronary artery bypass grafting (CABG) surgery under general anaesthesia were selected for the study. Participants were randomly allocated into two groups comprising 30 subjects each. Group I received lidocaine 1.5 mg/kg and group II (control) received a placebo (normal saline) 3 minutes prior to laryngoscopy. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were measured before induction as baseline, after intubation, at minute 1, 3, 5 and 7 minutes respectively after tracheal intubation while they were also observed for any complications. Results: There was a significant increase in HR, SBP, DBP, MAP and RPP in the control (placebo) group as compared to the lidocaine group (P < 0.05) at 1 minute with onward decreases at 3, 5, and 7 minutes respectively after intubation. Conclusions: Prophylactic therapy with lidocaine was found to be safe and effective in attenuating cardiovascular responses to laryngoscopy and tracheal intubation in patients posted for elective OPCABG on a low dose of ß-blockers.

Published in	Journal of Anesthesiology (Volume 1, Issue 3)
DOI	10.11648/j.ja.20130103.13
Page(s)	27-35
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Blood Pressure, Heart Rate, Intubation, Laryngoscopy, Lidocaine (Source: Mesh, NLM)

References

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[6]	Begum M, Akter P, Hossain MM, Alim SMA, Khatun UHS, Islam SMK. A comparative study between efficacy of esmolol and lignocaine for attenuating haemodynamics response due to laryngoscopy and endotracheal intubation. Faridpur Medical College Journal.2010; 5: 25-28.
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[16]	Abou-Madi MN, Keszler H, Yacoub JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Can Anaesth Soc J.1977; 24: 12-9.
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S. Singh, Kulsum, H. Shroff, A. Singh, A. Annamalai, et al. (2013). Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively. International Journal of Anesthesia and Clinical Medicine, 1(3), 27-35. https://doi.org/10.11648/j.ja.20130103.13

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ACS Style

S. Singh; Kulsum; H. Shroff; A. Singh; A. Annamalai, et al. Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively. Int. J. Anesth. Clin. Med. 2013, 1(3), 27-35. doi: 10.11648/j.ja.20130103.13

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AMA Style

S. Singh, Kulsum, H. Shroff, A. Singh, A. Annamalai, et al. Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively. Int J Anesth Clin Med. 2013;1(3):27-35. doi: 10.11648/j.ja.20130103.13

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@article{10.11648/j.ja.20130103.13,
  author = {S. Singh and Kulsum and H. Shroff and A. Singh and A. Annamalai and D. E. Mahrous},
  title = {Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {1},
  number = {3},
  pages = {27-35},
  doi = {10.11648/j.ja.20130103.13},
  url = {https://doi.org/10.11648/j.ja.20130103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20130103.13},
  abstract = {Background: Tachycardia and hypertension are well documented sequels of laryngoscopy and endotracheal intubation; they are transient, highly variable and are generally well tolerated in healthy patients. In hypertensive patients with coronary artery disease (CAD) these cardiovascular responses to laryngoscopy and intubation is exaggerated. The aim of this study was to evaluate the efficacy of lidocaine in attenuating cardiovascular response to laryngoscopy and endotracheal intubation in patients posted for elective off pump coronary artery bypass grafting (OPCABG) as these patients are on a low dose of ß-blockers. Materials and Methods: After obtaining institutional ethical approval, 60 patients aged 40 to 70 years from either sex of the American Society of Anaesthesiologists (ASA) physical status III with coronary artery disease (CAD) undergoing elective coronary artery bypass grafting (CABG) surgery under general anaesthesia were selected for the study. Participants were randomly allocated into two groups comprising 30 subjects each. Group I received lidocaine 1.5 mg/kg and group II (control) received a placebo (normal saline) 3 minutes prior to laryngoscopy. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were measured before induction as baseline, after intubation, at minute 1, 3, 5 and 7 minutes respectively after tracheal intubation while they were also observed for any complications. Results: There was a significant increase in HR, SBP, DBP, MAP and RPP in the control (placebo) group as compared to the lidocaine group (P < 0.05) at 1 minute with onward decreases at 3, 5, and 7 minutes respectively after intubation. Conclusions: Prophylactic therapy with lidocaine was found to be safe and effective in attenuating cardiovascular responses to laryngoscopy and tracheal intubation in patients posted for elective OPCABG on a low dose of ß-blockers.},
 year = {2013}
}

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TY - JOUR
T1 - Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively
AU - S. Singh
AU - Kulsum
AU - H. Shroff
AU - A. Singh
AU - A. Annamalai
AU - D. E. Mahrous
Y1 - 2013/12/20
PY - 2013
N1 - https://doi.org/10.11648/j.ja.20130103.13
DO - 10.11648/j.ja.20130103.13
T2 - International Journal of Anesthesia and Clinical Medicine
JF - International Journal of Anesthesia and Clinical Medicine
JO - International Journal of Anesthesia and Clinical Medicine
SP - 27
EP - 35
PB - Science Publishing Group
SN - 2997-2698
UR - https://doi.org/10.11648/j.ja.20130103.13
AB - Background: Tachycardia and hypertension are well documented sequels of laryngoscopy and endotracheal intubation; they are transient, highly variable and are generally well tolerated in healthy patients. In hypertensive patients with coronary artery disease (CAD) these cardiovascular responses to laryngoscopy and intubation is exaggerated. The aim of this study was to evaluate the efficacy of lidocaine in attenuating cardiovascular response to laryngoscopy and endotracheal intubation in patients posted for elective off pump coronary artery bypass grafting (OPCABG) as these patients are on a low dose of ß-blockers. Materials and Methods: After obtaining institutional ethical approval, 60 patients aged 40 to 70 years from either sex of the American Society of Anaesthesiologists (ASA) physical status III with coronary artery disease (CAD) undergoing elective coronary artery bypass grafting (CABG) surgery under general anaesthesia were selected for the study. Participants were randomly allocated into two groups comprising 30 subjects each. Group I received lidocaine 1.5 mg/kg and group II (control) received a placebo (normal saline) 3 minutes prior to laryngoscopy. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were measured before induction as baseline, after intubation, at minute 1, 3, 5 and 7 minutes respectively after tracheal intubation while they were also observed for any complications. Results: There was a significant increase in HR, SBP, DBP, MAP and RPP in the control (placebo) group as compared to the lidocaine group (P < 0.05) at 1 minute with onward decreases at 3, 5, and 7 minutes respectively after intubation. Conclusions: Prophylactic therapy with lidocaine was found to be safe and effective in attenuating cardiovascular responses to laryngoscopy and tracheal intubation in patients posted for elective OPCABG on a low dose of ß-blockers.
VL - 1
IS - 3
ER -

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Author Information

S. Singh

Department of Anaesthesia and Intensive Care, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, West Africa
Kulsum

Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India
H. Shroff

Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India
A. Singh

KNUST Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, West Africa
A. Annamalai

Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India
D. E. Mahrous

Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India

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APA Style

S. Singh, Kulsum, H. Shroff, A. Singh, A. Annamalai, et al. (2013). Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively. International Journal of Anesthesia and Clinical Medicine, 1(3), 27-35. https://doi.org/10.11648/j.ja.20130103.13

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ACS Style

S. Singh; Kulsum; H. Shroff; A. Singh; A. Annamalai, et al. Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively. Int. J. Anesth. Clin. Med. 2013, 1(3), 27-35. doi: 10.11648/j.ja.20130103.13

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AMA Style

S. Singh, Kulsum, H. Shroff, A. Singh, A. Annamalai, et al. Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively. Int J Anesth Clin Med. 2013;1(3):27-35. doi: 10.11648/j.ja.20130103.13

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@article{10.11648/j.ja.20130103.13,
  author = {S. Singh and Kulsum and H. Shroff and A. Singh and A. Annamalai and D. E. Mahrous},
  title = {Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {1},
  number = {3},
  pages = {27-35},
  doi = {10.11648/j.ja.20130103.13},
  url = {https://doi.org/10.11648/j.ja.20130103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20130103.13},
  abstract = {Background: Tachycardia and hypertension are well documented sequels of laryngoscopy and endotracheal intubation; they are transient, highly variable and are generally well tolerated in healthy patients. In hypertensive patients with coronary artery disease (CAD) these cardiovascular responses to laryngoscopy and intubation is exaggerated. The aim of this study was to evaluate the efficacy of lidocaine in attenuating cardiovascular response to laryngoscopy and endotracheal intubation in patients posted for elective off pump coronary artery bypass grafting (OPCABG) as these patients are on a low dose of ß-blockers. Materials and Methods: After obtaining institutional ethical approval, 60 patients aged 40 to 70 years from either sex of the American Society of Anaesthesiologists (ASA) physical status III with coronary artery disease (CAD) undergoing elective coronary artery bypass grafting (CABG) surgery under general anaesthesia were selected for the study. Participants were randomly allocated into two groups comprising 30 subjects each. Group I received lidocaine 1.5 mg/kg and group II (control) received a placebo (normal saline) 3 minutes prior to laryngoscopy. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were measured before induction as baseline, after intubation, at minute 1, 3, 5 and 7 minutes respectively after tracheal intubation while they were also observed for any complications. Results: There was a significant increase in HR, SBP, DBP, MAP and RPP in the control (placebo) group as compared to the lidocaine group (P < 0.05) at 1 minute with onward decreases at 3, 5, and 7 minutes respectively after intubation. Conclusions: Prophylactic therapy with lidocaine was found to be safe and effective in attenuating cardiovascular responses to laryngoscopy and tracheal intubation in patients posted for elective OPCABG on a low dose of ß-blockers.},
 year = {2013}
}

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