Comparison of two different pre extubation doses of intravenous lidocaine on hemodynamics and cough reflex at Tikure Anbessa specialized hospital, Addis Ababa, Ethiopia
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Date
2018-05
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Addis Ababa Universty
Abstract
Background: Hemodynamic and cough response during suctioning for extubation can cause
raised heart rate, blood pressures and coughing which could result bleeding, poor surgical
outcome such as graft release, increased intra cranial pressure (ICP), myocardial infarction(MI).
To prevent such problems the anesthetists, use different extubation techniques and medications
such as lidocaine.
Objectives: The objective of our study was to compare the difference in hemodynamic and cough
response to I.V lignocaine 1mg/kg (group1) and 1.5mg/kg (group2) and to evaluate the
comparative efficacy between the groups at peri-extubation period.
Methods: We conducted comparative observational study on one hundred thirty patients who
underwent elective surgical procedures requiring orotracheal intubation (OTI) and had given
1mg/kg (n=65) and 1.5mg/kg (n=65) plain lidocaine intravenous (IV). Hemodynamic parameters
like heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP) and mean
arterial pressure(MAP) were recorded at peri-extubation period and analysed using analysis
independent t test, paired t-test and chi-square /Fisher exact test. Post extubation cough was
graded as per Eshak’s grading (Grade 0, 1, 2 and 3). Results on continuous measurement
presented on Mean, standard deviation (SD). Significance had assessed at 5% level of
significance.
Results: Hemodynamic attenuation is observed in group2 as compared with their base line
values throughout the study period and hemodynamics between the groups at one minute of
extubation, three minute of extubation were significantly different. Hemodynamics difference at
tenth minute was not significant between the groups.
Conclusion: Hemodynamic suppression of lidocaine 1.5mg/kg at extubation is superior to
lidocaine 1mg/kg. Cough suppression of both groups are comparable.
Recommendation: We recommend the use of 1.5 mg/kg lidocaine than 1mg/kg lidocaine for suppressing hemodynamic and cough reflex at extubation.
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Keywords
hemodynamic response, cough, lidocaine, extubation