Key result
Pretreatment with a combination of diltiazem and lignocaine significantly attenuated the increases in systolic, diastolic, and mean arterial blood pressures following tracheal intubation compared to either drug alone (p<0.05).
Why the study?
Does lignocaine, diltiazem, or their combination attenuate cardiovascular responses to tracheal intubation in patients undergoing major elective surgery?
Cohort (n=45)
No
Does lignocaine, diltiazem, or their combination attenuate cardiovascular responses to tracheal intubation in patients undergoing major elective surgery?
Lignocaine, diltiazem, and their combination all result in a brief increase in blood pressure following tracheal intubation, though there are significant differences between the regimens.
Combination pretreatment was associated with attenuated BP response to intubation; hypothesis-generating, should not yet change practice.
Endotracheal intubation has turned out to be a routine procedure in the modern-day anesthesia care by the middle of the last century. However, this procedure results in transient cardiovascular changes, which could result in potential complication in physiologically deranged population. We conducted this study to compare the effects of two drugs, namely lignocaine and diltiazem alone and in combination in attenuating the deleterious effect of intubation on cardiovascular system. The setting of this prospective comparative study was government medical college Thiruvananthapuram. We studied 45 cases of ASA Gr. I & II between age groups 20-65 years, involving both sexes coming for major elective surgical procedures. Each group consisted of 15 patients. Heart rate, systolic and diastolic blood pressures were monitored at different time points. We analyzed the data with stata IC 15 software. The outcome measures were compared with repeated measures ANOVA. The median age with inter quarter range of the patients was 36(28-45) years. There were more females in the study groups (80percent). Systolic and diastolic pressure varied at different time points in the groups studied, within the groups and across the groups. Systolic and mean arterial pressure showed initial rise and later a downward trend across the group. There was a statistically significant difference between the three groups studied (p<0.05). The study revealed that SBP, DBP and MAP increased briefly after tracheal intubation in all patients who had received lignocaine, diltiazem or diltiazem plus lignocaine before intubation.
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Dr Rajan Babu (2017) conducted a cohort in Patients undergoing major elective surgical procedures requiring endotracheal intubation (n=45). Diltiazem and lignocaine combination vs. Diltiazem alone or lignocaine alone was evaluated on Changes in systolic blood pressure, diastolic blood pressure, and mean arterial pressure after tracheal intubation (p=<0.05). Pretreatment with a combination of diltiazem and lignocaine significantly attenuated the increases in systolic, diastolic, and mean arterial blood pressures following tracheal intubation compared to either drug alone (p<0.05).
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