Comparison of Intravenous Magnesium Sulphate and Lidocaine for Attenuation of Cardiovascular Response to Laryngoscopy and Endotracheal Intubation in Elective Surgical Patients at Zewditu Memorial Hospital Addis Abeba ,Ethiopia2018/2019.
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Date
2019-06
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Addis Ababa University
Abstract
Background: Laryngoscopy and endotracheal intubation are essential components of general anesthesia. But it is always associated with side effects called reflex cardiovascular responses. Many methods have been identified to attenuate these responses like intravenous lidocaine, deep inhalational anesthesia, vasodilators, intravenous magnesium sulphate even though therapeutic superiority remains understudied
Objective: To compare the effectiveness of intravenous lidocaine and magnesium sulphate for attenuation of cardiovascular responses after laryngoscopy and endotracheal intubation in elective surgical patients at Zewditu memorial hospital.
Methods: An institutional based cohort study on 112 adult patient age between 18-60 years was applied. 37 patients in non-exposed group (Group N), 37 in lidocaine group (Group L) and 38 in magnesium sulphate (Group M) were included. The hemodynamic parameters like HR, SBP, DBP, and MAP at various time points up to 7 minutes post-intubation were recorded and effect of both drugs to reduce hemodynamic responses was compared. Parametric data were analyzed using (ANOVA) and nonparametric data using Kuruska-Wallis H rank test.
Results: In all three groups, there was statistically significant rise in heart rate and blood pressure from baseline. There was statistically significant difference in mean heart rate throughout study minutes among the groups (p<0.001). However there was no statistically significant difference in mean heart rate between Groups M and L at all post intubation time intervals.
In blood pressure at all three parameters there was statistically significant difference among groups at all-time points except no difference at 7th minutes in DBP. There was significantly lower blood pressure in group M compared to both groups.
Conclusion and Recommendation: In conclusion prophylactic administration of magnesium sulphate and lidocaine were effective in attenuating haemodynamic responses to the stress effect of laryngoscopy and intubation but magnesium sulphate is better than lignocaine. We recommend that magnesium sulphate as alternative of lidocaine in attenuating hemodynamic response to laryngoscopy and intubation.
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Magnesium Sulphate and Lidocaine ,Surgical Patients .