Effectiveness of intraveneous lidocaine and fentanyl on attenuation of hemodynamic response to extubation for ear, nose and throat surgeries in yekatit 12 hospital medical college, Addis Ababa, Ethiopia 2018.
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Date
2018-06
Authors
Fenta, Efrem
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Publisher
Addis Ababa Universty
Abstract
Background: Tracheal extubation, the purposeful removal of the endotracheal tube from the trachea, can be associated with detrimental hemodynamic and airway responses. Lidocaine and fentanyl are known to suppress hemodynamic response to extubation during Ear, nose, and throat surgeries. Smooth tracheal extubation is important after Ear, nose, and throat surgeries.
Objective: To compare the effect of intravenous lidocaine and fentanyl on attenuation of hemodynamic response to extubation for Ear, nose, and throat (ENT) surgeries at Yekatit 12 Hospital Medical College.
Methods: This prospective cohort study recruits 74 American Society of Anesthesiologist (ASA) class I and II, age between 18 and 60 patients who underwent Ear, Nose and Throat surgeries. Unpaired T test was used to compare the mean of heart rate and mean arterial blood pressure between groups. Mann Whitney U Test was used for distribution free data. Association of categorical independent variables between two groups were analyzed using Chi Square or fisher exact test. P-values < 0.05 were considered as statistically significant with a power of 80%.
Results: The demographic and clinical characteristics were comparable between groups. The pulse rate and mean arterial blood pressure were significantly lower in fentanyl group at 1, 5, and 10 min after extubation with p values < 0.05. There was no statistically significant difference between two groups with decreasing the incidence of coughing in the Periextubation period with a p value of 0.857.
Conclusion and Recommendation: The findings of our study demonstrate that fentanyl 1μg/kg IV, administered 10 min before end of operation, was more effective in attenuating hemodynamic response to tracheal extubation compared with lidocaine 1.5 mg/kg IV in patients underwent ENT surgeries. We recommend that fentanyl administered 10 minutes before the end of operation for ENT surgeries is effective in attenuating hemodynamic response to extubation.
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Keywords
Tracheal extubation,hemodynamic