Key result
Lidocaine 1.5 mg/kg significantly attenuated increases in heart rate, blood pressure, and rate pressure product compared to placebo during intubation in patients undergoing CABG (P<0.05).
Why the study?
Does lidocaine 1.5 mg/kg attenuate haemodynamic responses to endotracheal intubation in patients with coronary artery disease undergoing elective CABG?
RCT (n=60)
Randomly allocated
No
Does lidocaine 1.5 mg/kg attenuate haemodynamic responses to endotracheal intubation in patients with coronary artery disease undergoing elective CABG?
p-value: p=<0.05
Prophylactic lidocaine 1.5 mg/kg effectively attenuates the exaggerated hemodynamic responses to laryngoscopy and intubation in CAD patients undergoing elective CABG.
Supports lidocaine 1.5 mg/kg before intubation in elective CABG; confirms hemodynamic attenuation in CAD patients.
Background: Tachycardia and hypertension are well documented sequels of laryngoscopy and endotracheal intubation; they are transient, highly variable and are generally well tolerated in healthy patients. In hypertensive patients with coronary artery disease (CAD) these cardiovascular responses to laryngoscopy and intubation is exaggerated. The aim of this study was to evaluate the efficacy of lidocaine in attenuating cardiovascular response to laryngoscopy and endotracheal intubation in patients posted for elective off pump coronary artery bypass grafting (OPCABG) as these patients are on a low dose of s-blockers. Materials and Methods: After obtaining institutional ethical approval, 60 patients aged 40 to 70 years from either sex of the American Society of Anaesthesiologists (ASA) physical status III with coronary artery disease (CAD) undergoing elective coronary artery bypass grafting (CABG) surgery under general anaesthesia were selected for the study. Participants were randomly allocated into two groups comprising 30 subjects each. Group I received lidocaine 1.5 mg/kg and group II (control) received a placebo (normal saline) 3 minutes prior to laryngoscopy. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were measured before induction as baseline, after intubation, at minute 1, 3, 5 and 7 minutes respectively after tracheal intubation while they were also observed for any complications. Results: There was a significant increase in HR, SBP, DBP, MAP and RPP in the control (placebo) group as compared to the lidocaine group (P < 0.05) at 1 minute with onward decreases at 3, 5, and 7 minutes respectively after intubation. Conclusions: Prophylactic therapy with lidocaine was found to be safe and effective in attenuating cardiovascular responses to laryngoscopy and tracheal intubation in patients posted for elective OPCABG on a low dose of s-blockers.
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Singh et al. (2014) conducted an RCT in Coronary artery disease (CAD) undergoing elective CABG (n=60). Lidocaine vs. Placebo (normal saline) was evaluated on Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) (p=<0.05). Lidocaine 1.5 mg/kg significantly attenuated increases in heart rate, blood pressure, and rate pressure product compared to placebo during intubation in patients undergoing CABG (P<0.05).
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