Pressor Response
Conditions
Keywords
pressor response, pre-eclampsia, Lignocaine
Brief summary
To study the effect of lignocaine nebulization on attenuation of the pressor response during induction and emergence of anesthesia in patients with severe pre-eclampsia
Detailed description
The pressor response to laryngoscopy and tracheal intubation is a very important issue in hypertensive pregnant patients that can lead to increased maternal intracranial pressure, cerebral haemorrhage, and cardiac failure with pulmonary oedema and may result in maternal mortality. The catecholamine release associated with laryngoscopy and intubation also causes uteroplacental vasoconstriction and adversely affect the neonate well-being. Therefore, the precise control of stress is necessary during general anesthesia in pre-eclamptic patients.Various drugs are used to suppress the pressor response including opioids, lidocaine, along with α and β adrenergic blockers. in this study the investigators will evaluate the effect of lignocaine nebulization on attenuation of the pressor response.
Interventions
DRUGLignocaine
preoperative nebulization of lignocaine
DRUGPlacebo
preoperative nebulization of normal saline (Nacl 0.9%) as a placebo
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologist (ASA) II , III with severe pre-eclampsia * Scheduled for caesarean deliveries under general anesthesia
Exclusion criteria
* severe obesity (BMI ≥ 40 ) * Cardiac patients * History of diabetes * Renal dysfunction (Elevated creatinine ≥ 2 mg\\dl) * Hepatic dysfunction (Elevated hepatic enzymes three times above normal value) * Known fetal anomalies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Systolic, diastolic, mean arterial blood pressure | Preoperative-Intraoperative | — |
| Heart rate | Preoperative-Intraoperative | — |
| Peripheral oxygen saturation | Preoperative-Intraoperative | — |
| Cough score during emergence | Up to one hour after extubation | Grade of coughing (grade 0: no cough; grade 1: single cough with mild severity; grade 2: cough lasting less than 5 seconds with moderate severity; grade 3: more than 5 seconds of persistent cough) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| APGAR score | One, 5 and 10 minutes after delivery of the fetus | APGAR stands for Appearance, Pulse, Grimace, Activity, and Respiration. In the test, five things are used to check a baby's health. Each is scored on a scale of 0 to 2, with 2 being the best score |
| Sore throat and hoarseness of voice | Postoperative (one, 6 and 24 hours) | The incidences and severities of postoperative sore throat and hoarseness of voice will be measured using direct questions |
Countries
Egypt
Contacts
Primary ContactFatma N. Mohamed, M.D.
Backup ContactAlaa A. Gharib, M.B.B.Ch.
Outcome results
None listed