Publications
EFFECT OF INTRAVENOUS LIDOCAINE, INTRAVENOUS ESMOLOL AND INTRAVENOUS CLONIDINE ON HAEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND ORO-TRACHEAL INTUBATION IN NORMOTENSIVE PATIENTS: A DOUBLE BLINDED, COMPARITIVE STUDY
Dr. Savitha K. S. Dr. Sunanda S. Dr. Rajesh Vijayan The pressure response to laryngoscopy and endotracheal intubation is without
sequel in healthy individuals. In patients with pre-existing diseases, may precipitate myocardial
ischemia, arrhythmias, infarction and cerebral hemorrhage. In view of that, the objectives of our
study was, to assess the hemodynamic variations to laryngoscopic intubation and to evaluate the
comparative efficacy of I.V Lidocaine, I.V Esmolol and I.V Clonidine, in attenuating the sympathetic
response to laryngoscopy and orotracheal intubation in normotensive patients. METHODS: In our
double blind, randomized, clinical prospective study 105 Indian ethnicity patients of either sex
requiring oral intubation, who met inclusion criteria, were considered. Randomly patients were
stratified into three groups (n=35 patients each) Group C, Group E and Group L to receive inj
Clonidine 1.5 μg/kg, inj Esmolol 1.5 mg/kg and inj Lidocaine 1.5 mg/kg respectively at 15min, 3min
and 3min prior to intubation as premedication. Two senior postgraduates who were not involved in
patient care were responsible for blinding techniques. Data obtained were analyzed after decoding.
Analysis of variance (ANOVA), Chi-square/Fisher Exact test has been used to find the significance of
study parameters on categorical scale between the three groups. RESULTS: In our study there was
strongly significant raise in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure
(DBP) and mean arterial pressure (MAP) at one minute following intubation in all three groups (p
<0.001). HR reached base line at 4min in group E which was statistically significant (p <0.001). In
group C, SBP and DBP reached base line value in 2 min and 3 min Which is again statistically
strongly significant (p <0.001). CONCLUSION: Esmolol 1.5 mg/kg I.V, 3 min prior to oro-tracheal
intubation is a better drug of choice to control HR and Clonidine 1.5 μg/kg I.V, 15 min prior to
orotracheal intubation is preferred to attenuate hypertensive response to laryngoscopy and
intubation in a normotensive patients.
