Comparison of the effects of intravenous lidocaine and propofol administration on attenuation of hemodynamic response during extubation in adult elective surgical patient at Asella teaching and referral hospital in 2019/20.(Prospective cohort study design)
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Date
2020-05
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Addis Abeba University
Abstract
Background: Tracheal extubation is the process of removing a tube from the trachea which is
associated with an increased in heart rate, blood pressure, intracranial and intraocular pressure,
coughing, bronchospasm and increased bleeding. Many techniques as well as drugs have been
proposed for attenuation of airway and cardiovascular responses. Propofol and lidocaine are
widely available drugs in resource limited setting though their relative effectiveness for smooth
extubation is not well established.
Objectives:To compare the effectiveness of intravenous lidocaine and propofolon attenuation of
extubation induced hemodynamic responses in adult elective surgical patient from Nov 1,2019
– Feb 2020 at Asella teaching and referral hospital, Ethiopia.
Methods: A prospective cohort study design was conducted on 72 eligible patients at Asella
teaching and referral hospital from Nov 1/2019-Feb 30/2020. The study participant were
allocated into three group; Group P(n=24)received 0.5 mg/kg propofol, group L(n=24)received 1.5 mg/kg lidocaine two minute prior to extubation and group C(n=24) were control
groups. Data was collected using adopted and prepared questionnaires byobservation and chart
review methods. Data was entered in to SPSS version 20 computer software and analyzed using
one way ANOVA. Normality of the data was checked by Shapiro wilktest andTukeypost hoc test
was used to compare difference between groups.p-value of <0.05 was considered as statistically
significant.
Results: After extubationheart rate, systolic, diastolic and mean arterial pressure decreased
significantly in propofol and lidocaine groups than control group up to 10 minute. Heart rate,
diastolic and mean arterial pressure was lower in group of propofol up to 5 minute and systolic
blood pressure up to 3 minutes post extubation.Heart rate, diastolic and mean arterial pressure
was lower in group of lidocaine after 5 minute and systolic blood pressure after 3 minutes post
extubation.(p=0.001)
Conclusions and recommendations:The administration of 0.5 mg/kg propofol or 1.5mg/kg
lidocaine might help for attenuating extubation induced hemodynamic responses. We recommend
anesthetist to use 0.5 mg/kg propofol or 1.5mg/kglidocaine for attenuating extubation
induced hemodynamic response.
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Keywords
Propofol, Lidocaine, Extubation, hemodynamic responses