International Journal of Anesthesia and Clinical Medicine

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

Received: 16 September 2013    Accepted:     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.

DOI 10.11648/j.ja.20130103.13
Published in International Journal of Anesthesia and Clinical Medicine (Volume 1, Issue 3, November 2013)
Page(s) 27-35
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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), 2024. Published by Science Publishing Group

Keywords

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

References
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[2] Ishikawa T, Nishino T, Hiraga K. Immediate response to arterial blood pressure and heart rate to sudden inhalation of high concentration of isoflurane in normotensive and hypertensive patients. Anesth Analg.1993; 77: 1022-5.
[3] Slogoff S, Keats AS. Does perioperative myocardial ischemia lead to postoperative myocardial infarction? Anesthesiology.1985; 62: 107-114.
[4] Tian-long W, Yan J, Ba-xian Y. Effect of nicardipine combined with esmolol on systemic and tissue oxygenation during off-pump coronary artery bypass grafting surgery.Chin Med J.2005;118:130-5.
[5] Takita K, Morimoto Y, Kemmotsu O. Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation. Can J Anaesth 2001; 48: 732-6.
[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.
[7] Miller CD, Warren SJ. Intravenous lignocaine fails to attenuate the cardiovascular response to laryngoscopy and tracheal intubation. Br J Anaesth.1990; 65: 216‑9.
[8] Gonzalez P, Cuccurullo S, Jafri I, Luciano L. Cardiac Rehabilitation. Physical Medicine and Rehabilitation Board Review.2004; Bookshelf ID: NBK27286.
[9] Savio KH, Tait G, Karkouti K, Wijeysundera D, McCluskey S, Beattie WS. The Safety of Perioperative Esmolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Anesthesia & analgesia.2011; 112: 267-281.
[10] Landesberg G, Beattie WS, Mosseri M, Jaffe AS, Alpert JS. Perioperative Myocardial Infarction. Circulation.2009; 119: 2936-44.
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Author Information
  • 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; Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India

  • Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India; Department of Anaesthesia, Zainoel Abidin Hospital, Banda Aceh, Indonesia

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

  • KNUST Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, West Africa

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

  • Department of Cardiac Anaesthesia, NHIMS, Bangalore, Karnataka, India; Centre Chirurgical Marie Lannelongue, Universite Paris-Sud, France

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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://download.sciencepg.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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    T1  - Can Sodium Channel Blocker Lidocaine Attenuate Haemodynamic Responses to Endotracheal Intubation in Patients with Coronary Artery Disease Effectively
    AU  - S. Singh
    AU  - Kulsum
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    AU  - A. Annamalai
    AU  - D. E. Mahrous
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    T2  - International Journal of Anesthesia and Clinical Medicine
    JF  - International Journal of Anesthesia and Clinical Medicine
    JO  - International Journal of Anesthesia and Clinical Medicine
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    PB  - Science Publishing Group
    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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