Contents
Download PDF
pdf Download XML
341 Views
134 Downloads
Share this article
Research Article | Volume 13 Issue:3 (, 2023) | Pages 286 - 293
Hemodynamic stress response to endotracheal extubation with the combination of Diltiazem-Lignocaine, Esmolol-Lignocaine and Lignocaine alone - A prospective comparative randomized study
Under a Creative Commons license
Open Access
Received
June 18, 2023
Revised
June 30, 2023
Accepted
July 14, 2023
Published
July 31, 2023
Abstract

Background: Endotracheal extubation causes transient hemodynamic stimulation leading to increase in blood pressure and heart rate due to increase in sympathoadrenergic activity caused by epipharyngeal and laryngopharyngeal stimulation. Lignocaine, a Sodium channel blocker attenuates the hemodynamic response to tracheal extubation by inhibiting sodium channels in the neuronal cell membrane, decreasing the sensitivity of the heart muscles to electric impulses. Diltiazem, a Calcium channel blocker attenuates hemodynamic response by blocking voltage sensitive L type channels, and inhibiting calcium entry mediated action potential in smooth and cardiac muscle. It also has peripheral vasodilation property. Esmolol, a Beta blocker attenuates hemodynamic response by blocking sympathetic nervous system. Methodology- 90 patients admitted for elective surgeries posted under general anaesthesia at Kidwai memorial institute of oncology, Bangalore during the duration of December 2018 to May 2019 were included in the study. Patients were randomly divided into 3 groups of 30 each. Randomization done by computer generated table. Group A: received Inj. Diltiazem 0.1mg/kg and preservative free lignocaine 1mg/kg. Group B: received Inj. Esmolol 0.5mg/kg and lignocaine 1mg/kg. Group C: received Inj. lignocaine 1mg/kg. Hemodynamic parameters HR, SBP, DBP, MAP were recorded before extubation (pre reversal) and 1min, 2mins, 3mins, 5mins and 10mins post extubation. In this study, the dosage was fixed based on previous studies. Results- Post extubation, the decrease in mean heart rate was statistically significant in Group B in comparison with Group C (control group) from 1 min post extubation till 10 min. There was increase in heart rate in Group A compared to Group C (control group) which is not statistically significant. Also there was slight decrease in heart rate in Group B compared to Group A (both study group) which is statistically significant at all the intervals. Conclusion- Smaller doses of esmolol when combined with lignocaine gives much better results when compared to Diltiazem + Lignocaine combination and lignocaine alone.

Keywords
Recommended Articles
Research Article
Study Of Hematological Abnormalities in Decompensated Chronic Liver Disease
...
Published: 30/06/2025
Download PDF
Research Article
Role of Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria in prediction of clinical outcomes in patients with acute coronary syndrome
...
Published: 30/09/2025
Download PDF
Research Article
Comparison of Intravenous Magnesium Sulphate and Clonidine in Attenuating Hemodynamic Responses during Laryngoscopy and Tracheal Intubation: A Prospective Randomized Double-Blind Study
Published: 30/09/2020
Download PDF
Research Article
A Study Comparing Pre- Operative Prophylactic Iv Antibiotics with Combined IV and Intraincisional Antibiotics Administration for Reducing Surgical Site Infections
...
Published: 27/09/2025
Download PDF
Chat on WhatsApp
Copyright © EJCM Publisher. All Rights Reserved.