Browsing by Author "Samuel, Hirbo"

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    Comparison of intravenous fentanyl and lidocaine as an anesthetics adjuvant on attenuation of hemodynamic pressor responses to laryngoscopic intubation at Tikure Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2018-06) Samuel, Hirbo; Weldeyohannes, Misrak(Mrs.MSc in Anesthesia)
    Back ground: Laryngoscopic intubation is an insertion of endotracheal tube in to the trachea for maintenance of airway during general anesthesia. Smooth intubation requires attenuation of pressor responses and maintenance of baseline hemodynamic stability. In order to control hemodynamic changes during tracheal intubation and extubation, local anaesthetics, opioids, beta-blocking agents, and calcium channel blockers have been used with varying success rates. Objective: To compare intravenous fentanyl and lidocaine on attenuation of hemodynamic responses to Laryngoscopic intubation in elective surgical patient at Tikur Anbessa Specialized Hospital (TASH) Addis Ababa, Ethiopia. Methods: An institutional based observational prospective cohort study was conducted on one hundred and Fourteen eligible adult patients at TASH from January 1, to March 30, 2018. The study participants were allocated in to two group; Group F (n =57) patients received fentanyl 2mcg/kg and Group L (n =57) patients received lidocaine (2%) 1.5mg/kg three minute before intubation. Observation and chart review were employed for data collection. Data was entered in to Epi info version 7.2 software by investigators and transported to SPSS version 20 program for analysis. Normality of the data was checked by Shapiro wilk test. Independent t- test was used to determine the mean differences between two groups while paired sample t- test was used to determine the mean differences within the groups. Chi square test was used for categorical variables. Those variables with p-value < 0.05 were considered as statistically significant. Results: The heart rate was significantly lower in fentanyl group (98.91±15.6 bpm) compared to lidocaine (107 ±15.45 bpm) at first minute after intubation, t (112) =2.8, p = 0.006. Systolic blood pressure was also significantly lower in fentanyl group (141.9±18.9 mmHg) compared to lidocaine (150mmHg ±18.098 mmHg), t (112) = 2.45, p = 0.016. At third minute after intubation heart rate was lower in fentanyl group compared to lidocaine, t (112), p= 0.037. No difference in heart rate and blood pressure among the group at 5th minute after intubation (p>0.05). Conclusion and recommendations: Fentanyl was better on attenuation of hemodynamic pressor responses to intubation when compared to lidocaine. Therefore, using fentanyl pre-operatively to attenuate pressor responses especial during intubation is important.