Cardiovascular diseases
Conditions
Interventions
Total 220 patients divided into 4 groups of 55 each
Experimental group : 55 ASA I/II patients will receive injection Lignocaine 1.5mg/kg iv given 90 seconds before laryngoscopy
Experimental group
Drug
Sponsors
Government medical college haldwani
Government medical college haldwani
Eligibility
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: Patients equal to or greater than 18 years and equal or lesser than 60 years of age;Patients weighing equal to or greater than 40kg and equal or lesser than 90 kgs of either sex and BMI equal to or greater than 18.5 and equal or lesser than 24.9 of either sex;Patients posted for elective Surgical Procedure belonging to ASA physical status – Grade I and II;Patients requiring general Anesthesia and Endotracheal Intubation.
Exclusion criteria
Exclusion criteria: Patient / guardian refusal for consent;ASA grade III and IV;Emergency surgeries;Patients between age greater than 60 years and Age lesser than 18 years;Patients weighing greater than 90kg and lesser than 40kg and BMI lesser than 18.5 and greater than 24.9;Patients suspected to have difficult tracheal intubation;Patients on beta-blockers or calcium channel blockers;Patients with significant renal (serum creatinine greater than 1.5mg/dl) ,hepatic (serum total bilirubin greater than 1.2 mg/dl, serum total protein lesser than 6g/dl & greater than 8.5g/dl ,serum albumin lesser than 3.5g/dl & greater than 5g/dl , serum SGPT greater than 40u/l , serum SGOT greater than 56u/l) disease;Hypertensive patients systolic blood pressure greater than 160 mmHg and or diastolic blood pressure greater than 95 mmHg;Patients with chronic obstructive lung diseases especially bronchial asthma;Diabetic patients on treatment;Patients with significant heart disease like past history of angina or myocardial infarction , heart blocks , and congestive cardiac failure;Laryngoscopy and intubation exceeding 20 seconds
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expected to find the attenuation of hemodynamic changes in patients to laryngoscopy and tracheal intubation using intravenous esmolol, lidocaine, and diltiazem and observed at baseline, after drug administration, immediately after intubation, and at 1, 3, and 5 min after intubation,verfied by transforming the collected data into variables which were coded and entered in Microsoft Excel. Data were analyzed and statistically evaluated using SPSS-PC-17 version.Quantitative data was expressed in mean, standard deviation and difference between three or more comparable groups were tested by one way ANOVA or Kruskal Wallis H test followed by post hoc test, while qualitative data were expressed in percentage. Statistical differences between the proportions were tested by chi square test or Fisher’s exact test. ‘P’ value less than 0.05 was considered statistically significant,it was observed that Pre-operative mean heart rate was comparable in all four groups. The heart rate was significantly lower in Group E (Esmolol group), followed by Group D (Diltiazem group) and Group L (Lignocaine group) from drug administration to study observation period. Maximum increase in HR occurred just after laryngoscopy.During the observation period, Rise in systolic blood pressure was lower in group D (Diltiazem group) until 5 minutes after intubation after which it was lower in group E (Esmolol group) as compared to other groups (Lignocaine and Normal Saline group). Diastolic blood pressure was also lower in group D (Diltiazem group) compare to other groups. It was significantly lower after 1 min of intubation compare to other groups before that it was lower but statistically not significant. After Diltiazem, diastolic blood pressure was lower in Esmolol group compare to lignocaine and normal saline group.The MAP was increased maximum in Normal saline group as compared to other groups following laryngoscopy and intubation. The maximum increase in MAP over the baseline values (95.29±8.62, 97. | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected to ascertain the superiority of one drug over the other in suppressing sympathetic response to laryngoscopy and tracheal intubation,verfied by transforming the collected data into variables which were coded and entered in Microsoft Excel. Data were analyzed and statistically evaluated using SPSS-PC-17 version.Quantitative data was expressed in mean, standard deviation and difference between three or more comparable groups were tested by one way ANOVA or Kruskal Wallis H test followed by post hoc test, while qualitative data were expressed in percentage. Statistical differences between the proportions were tested by chi square test or Fisher’s exact test. ‘P’ value less than 0.05 was considered statistically significant, it was observed that esmolol was superior in attenuating heart rate and diastolic blood pressure as compared to diltiazem and lignocaine while diltiazem was superior in attenuating systolic blood pressure as compared to esmolol and lignocaine . | — |
Countries
India
Contacts
Public ContactSathya Narayanan K
Government medical college haldwani
Outcome results
None listed