General Anesthesia
Conditions
Keywords
Haemodynamic Response, Endotracheal Intubation, Dexmedetomidine, Lidocaine
Brief summary
Endotracheal intubation is considered a definitive therapy and the gold standard for airway management. However, this procedure carries several risks, including sudden increases in blood pressure and heart rate. These spikes in blood pressure and heart rate can be tolerated by healthy individuals, but for patients with cerebrovascular and cardiovascular risk factors, they can be extremely dangerous and even life-threatening. Various techniques and drug choices can be employed to prevent the hemodynamic surges associated with endotracheal intubation, including the use of anesthetic drugs from the α2-adrenergic agonist and amide classes. One of the α2-adrenergic agonists commonly used to prevent hemodynamic surges during endotracheal intubation is dexmedetomidine, while one of the amide drugs frequently used for this purpose is lidocaine.
Detailed description
Dexmedetomidine works very selectively on noradrenergic receptors distributed both within and outside the central nervous system, particularly in the pons and medulla. Presynaptic stimulation of α2 receptors can reduce the release of norepinephrine and the activation of postsynaptic α2 receptors. Lidocaine works by inhibiting sodium channels within cells, preventing the occurrence of action potentials and the transmission of impulses along nerves. Lidocaine also acts by blocking calcium and potassium channels as well as N-methyl-D-aspartate (NMDA) receptors.
Interventions
DRUGDexmedetomidine
Patient in experimental arms will received intravenous dexmedetomidine at a dose of 0.5 µg/kg body weight 10 minutes before general anesthesia induction
DRUGLidocain
Patient in experimental arms will receive intravenous lidocaine at 1.5 mg/kg body weight in a 5cc syringe 90 seconds before intubation
Sponsors
Universitas Padjadjaran
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to 59 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients aged 18-59 years. * Patients scheduled for oral intubation. * Physical status ASA I and II (American Society of Anesthesiologists). * Patients with Mallampati classification I-II.
Exclusion criteria
* History of allergy to the drugs that will be used. * Pregnant patients. * Patients taking medications that affect blood pressure and heart rate, such as vasodilators, adrenergic blockers, antiarrhythmics, and cardiac stimulants. * Patients with arrhythmias, AV block, liver disorders, hypertension, and hypoalbuminemia. * Patients who have been given opioids within the last 24 hours. * Patients with predicted intubation difficulties.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Systolic blood pressure | Right after endotracheal intubation until 5 minutes after endotracheal intubation |
| Diastolic blood pressure | Right after endotracheal intubation until 5 minutes after endotracheal intubation |
| Heart rate | Right after endotracheal intubation until 5 minutes after endotracheal intubation |
Countries
Indonesia
Outcome results
None listed