A Study of the Efficacy of Cardiac Antidysrhythmic Drugs in Attenuating Haemodynamic Responses to Laryngoscopy and Endotracheal Intubation in the Black Population
Sanjeev Singh,
Edwin Ferguson Laing,
William Kwame Boakye Ansah Owiredu,
Arti Singh,
Anbarasu Annamalai
Issue:
Volume 1, Issue 1, July 2013
Pages:
1-8
Received:
23 May 2013
Published:
30 June 2013
DOI:
10.11648/j.ja.20130101.11
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Abstract: Background: Laryngeal, tracheal and bronchial receptors are stimulated by mechanical and chemical irritants during laryngoscopy and endotracheal intubation. That almost always triggers powerful cardiovascular responses. Various attempts have been made to attenuate these responses. The aim of this study was to compare the efficacy and safety of cardiac antidysrhythmic drugs lidocaine, diltiazem and esmolol in the attenuation of cardiovascular responses to endotracheal intubation in the Black normotensive population. Patients and Methods: A randomized controlled trial was conducted in 160 adult patients of ASA physical status I or II undergoing various elective surgeries. The patients were randomly divided into four groups of 40 patients in each group - C, L, D, and E. Group - “C” received no drug (control) as placebo, group -“L” received 1.5 mg kg-1 preservative free lidocaine, group -“D” received 0.2 mg kg-1 diltiazem, and group-“E” received 2mg kg-1 esmolol IV. Group “C”, “D” and “E”, “L” one and two minutes before intubation. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured and then compared within and between groups. Rate pressure product (RPP) was calculated and evaluated as well. Patients were also observed for any complications. Result: There was a significant increase in SBP, DBP, HR, MAP and RPP from the base line in control group “C” at 1 minute with onward decreases at 3 and 5 minutes respectively after intubation. Percentage change in haemodynamic variables in groups C, L, D and E at 1 minute are as follows: SBP= 23.58%, 11.84%, 9.64% and 9.9%, DBP= 18.73%, 18.89%, 11.93% and 10.40%, HR= 30.45%, 26.00%, 7.01% and 1.50%; MAP= 20.80%, 15.89%, 10.90 and 10.20%; RPP= 61.44%, 40.86%, 17.26% and 11.68% respectively. Only patients receiving placebo had increased SBP, DBP, HR, MAP and RPP values after intubation compared with baseline values (p < 0.05). Conclusions: Given the difference in the pharmacological mechanisms of these drugs, the prophylactic therapy with 2mg kg-1 esmolol is significantly more effective and safe for attenuating haemodynamic changes to laryngoscopy and tracheal intubation, without producing increased risk of hypertension in the Black population.
Abstract: Background: Laryngeal, tracheal and bronchial receptors are stimulated by mechanical and chemical irritants during laryngoscopy and endotracheal intubation. That almost always triggers powerful cardiovascular responses. Various attempts have been made to attenuate these responses. The aim of this study was to compare the efficacy and safety of card...
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Effects of Adjuvant Dexketoprofen in Regional Intravenous Anesthesia
Ersin Ozgur Sahin,
Kenan Kaygusuz,
Ahmet Cemil Isbir,
Cevdet Duger,
Iclal Ozdemir Kol,
Sinan Gursoy,
Caner Mimaroglu
Issue:
Volume 1, Issue 1, July 2013
Pages:
9-14
Received:
7 June 2013
Published:
20 August 2013
DOI:
10.11648/j.ja.20130101.12
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Abstract: Background and objectives: In our study, it is aimed to investigate the effectiveness of the use of local anesthetics by the addition of adjuvant drugs to the patients who had hand surgery with regional intravenous anesthesia. In this context, contributions of non-steroidal anti-inflammatory agent to the local anesthetics as adjuvant medication during and after surgery for the patients and their positive and negative effects on the patients were evaluated. Methods: The Study was designed to cover backward date range of January 2010-August 2011 period of University Hospital Operating Room records of the hand surgery patients operated with regional intravenous anesthesia (RIVA) and those were evaluated. Total 44 patients’ records retrospectively evaluated. The patients treated with prilocaine were selected as control group (Group 1), the other 22 patients treated with prilocaine and Dexketoprofen were selected as the adjuvant drug added group for the RIVA process (Group 2). The sensory and motor block onset and end times of the patients, the surgical wound pain VAS values and also VAS scores that could be derived from tourniquet pain were examined. Results: We found the positive impact on the patients, in terms of pain, as statistically significant, by the use of non-steroidal anti-inflammatory drug as an adjuvant, during and after surgery, for the RIVA technique. In this study, the starting and ending times of sensory and motor block, surgical wound VAS scores, tourniquet VAS scores measurements were taken. The mean onset time of sensorial block of Group I was calculated as 9.4 min, whereas Group II, mean onset time of sensorial block was calculated 7.09 min. In Group 2, 40 Minutes after the tourniquet had a lower VAS scores. Conclusion: It is concluded that, in the first 24 hours in RIVA, intraoperative and postoperative analgesic requirement was reduced by Dexketoprofen.
Abstract: Background and objectives: In our study, it is aimed to investigate the effectiveness of the use of local anesthetics by the addition of adjuvant drugs to the patients who had hand surgery with regional intravenous anesthesia. In this context, contributions of non-steroidal anti-inflammatory agent to the local anesthetics as adjuvant medication dur...
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