European Journal of Cardiovascular Medicine

Background: Endotracheal extubation is one of the frequently performed procedure in the practice of Anaesthesia. This study was done to observe the haemodynamic responses during tracheal extubation and to compare the efficacy of IV diltiazem 0.3 mg/kg wih IV Lidocaine 1 mg/kg  versus 0.2 mg/kg and 0.1 mg /kg IV Diltiazem with 1mg/kg IV Lignocaine in attenuating the hemodynamic response to tracheal extubation.

Methods: 120 patients aged 20 to 60 yrs, belonging to ASA I and II, normotensive were included in the study and they were randomly allocated into 3 groups of 40 each.

•Group –I The patient who receive injection Diltiazem 0.1mg/kg and inj Lignocaine 1mg/kg i.v. (n=40)

• Grade –II The patients who receive injection Diltiazem 0.2mg/kg and inj.Lignocaine 1mg/kg i.v. (n=40)

•Group -III The patients who receive injection Diltiazem 0.3mg/kg and inj.Lignocaine 1mg/kg i.v. (n=40) 2 min before extubation. At the end of the surgery, heart rate (HR), systolic blood pressure (SBP)  diastolic blood pressure (DBP) and mean arterial pressure [MAP]  were recorded served as base line values.

Results: After tracheal extubation, all the haemodynamic parameters increase from base line ,0.3 mg/kg inj. Diltiazem along with 1mg/kg inj Lignocaine provide better haemodynamic stability when compared with 0.1 mg/kg and 0.2 mg/kg inj Diltiazem along with inj. Lignocaine 1mg/kg each. 0.2 mg/kg inj.Diltiazem along with 1mg/kg inj Lignocaine provide better haemodynamic stability when compared with 0.1 mg inj Diltiazem with inj. Lignocaine 1mg/kg.

Conclusions: Based on the findings of our study, we concluded that combination effect of Inj. Lignocaine and Inj. Diltiazem, Attenuate the hemodynamic response to extubation.

0.3mg/kg Diltiazem with 1mg/kg Lignocaine is superior to 0.2mg/kg and 0.1 mg/kg Diltiazem with 1mg/kg Lignocaine in attenuating the hemodynamic response to extubation.

0.2mg/kg Diltiazem with 1mg/kg Lignocaine is superior to 0.1mg/kg Diltiazem with 1mg /kg lignocaine in attenuating the hemodynamic response to extubation.