Indian Journal of Applied Basic Medical Sciences
Year: 2021, Volume: 23(B), Issue. (2)
First page: (86) Last page: (102)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi: 10.48165/ijabms.2021.233707 

Comparison Of Lignocaine And Fentanyl For  Attenuation Of Cardiovascular Stress Response To  Laryngoscopy And Endotracheal Intubation
Dr. Hetavi Arth Shah1, Dr. Sonal A. Shah2*
1Assistant Professor, Department of Anaesthesia, SVP hospital, Smt. N.H.L. MMC, Ahmedabad.
2Assistant Professor, Department of Anaesthesia, SVP hospital, Smt. N.H.L. MMC, Ahmedabad. 
Corresponding Author: Dr. Sonal A. Shah , Email:

Online Published on 25-August-2021

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ABSTRACT

BACKGROUND AND AIM Intravenous Fentanyl Citrate and Lignocaine hydrochloride is being used as premedication for  general anaesthesia with an intent to attenuate cardiovascular reflexes of laryngoscopy and  endotracheal intubation. Present study was aimed to compare efficacy of both drugs as  premedication to attenuate cardiovascular reflexes of laryngoscopy. METHODOLOGY Present study was carried out on randomly selected 50 patients of ASA Grade 1 and 2, aged 20  to 50 years with mallam pati airway assessment grade 1 scheduled for elective surgery  requiring general anaesthesia with endotracheal intubation. All routine non-invasive monitors  were applied and iv line secured. Glycopyrrolate 0.004 mg/kg and injection midazolam 0.02  mg/kg was given intravenously and IV infusion of ringer lactate was started. Patients were divided in two groups. Group-1: -Lignocaine hydrochloride group. Here patients received injection lignocaine  hydrochloride 1.5 mg / kg IV bolus 3 minutes prior to induction. Group-2: -Fentanyl citrate group. Here patients received injection fentanyl citrate 2 µg / kg IV  bolus 3 minutes prior to induction. After preoxygenation general anaesthesia with Thiopentone Sodium 5mg/kg and Succinyl  choline 2mg/kg was given and endotracheal intubation was done. Heart rate, SBP, DBP, MAP  and ECG were recorded in all patients pre operatively, after premedication, before study drug,  after induction, after laryngoscopy and intubation and for every 1 minute up to 6 minutes after  intubation during which no stimulus was given to patients. Laryngoscopy done and  endotracheal intubation was done. An observation was made related to adverse effects of drugs and laryngoscopy related problems  and were attended to appropriately. RESULTS In our study, injection fentanyl citrate 2 µg/kg attenuated the haemodynamic response better  than Lignocaine 1.5 mg/kg. Heart rate, systolic blood pressure, diastolic blood presuure and mean arterial pressure did not rise significantly after intubation with Fentanyl compared to  Lignocaine and reached basal value within study time. CONCLUSION Fentanyl citrate is safe and effective in attenuation of hemodynamic response to laryngoscopy  without significant side effects as compared to lignocaine hydrochloride.

Keywords

Lignocaine, Fentanyl, Attenuation, Cardiovascular