Comparison of the efficacy of esmolol and lidocaine in the control of hemodynamic response associated with intubation: A randomized controlled trial

Yıl 2013, Cilt: 4 Sayı: 1, 20 - 27, 01.03.2013

Tolga Ergönenç Jalan Şerbetçigil Uğur Uzun Ali Dirik Gülşen Bican

https://doi.org/10.5799/ahinjs.01.2013.01.0228

Öz

Objectives: The purpose of this randomized study is to compare the effects of esmolol and lidocaine in the con­trol of hemodynamic response caused by endotracheal intubation. Methods: In this study, 40 patients with ASA I-II physical status and between the ages of 19 and 76 were included and randomly divided into two groups. In the Group E (n = 20), iv bolus injection of 1.5 mg/kg esmolol, in the Group L (n = 20), iv bolus injection of 1.5 mg/kg 2% lidocaine were given with iv bolus injection in 30 seconds. All pa­tients received the same anesthetic technique. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) and heart rate measure­ments were done at specified times and recorded. Re­cords were assessed by an anesthesiologist blinded to which drug is applied. Results: There was no difference between the groups in demographic data (p>0.05). In both groups, with the implementation of the study drug, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure decreased compared to controls, this reduction was lower in Group E than Group L. In Group L, SBP values of 1.5 and 7 minutes were higher than Group E (p

Anahtar Kelimeler

Esmolol, lidocaine, intubation, hemodynamic response

Entübasyona bağlı hemodinamik yanıtın kontrolünde esmolol ve lidokainin etkinliğinin karşılaştırılması: Randomize kontrollü çalışma

Öz

Amaç: Bu randomize çalışmanın amacı endotrakeal en­tübasyonun neden olduğu hemodinamik yanıtın kontolün­de esmolol ve lidokainin etkilerini karşılaştırmayı amaçla­maktır. Yöntemler: Bu çalışmaya ASA I-II olan 19 ve 76 yaşları arasında 40 hasta dâhil edildi. Rastgele olarak iki grubuna ayrıldı. Grup E\' ye (n=20) 1,5 mg/kg esmolol, Grup L\'ye (n=20) 1.5 mg/kg %2 lidokain i.v bolus olarak 30 saniye­de anestezist tarafından uygulandı. Tüm hastalara aynı anestezi tekniği uygulandı. Sistolik kan basıncı (SKB), diastolik kan basıncı (DKB) ve ortalama kan basınçları (OKB) ile kalp atım hızı için belirlenen zamanlarda ölçüm­ler yapılarak kaydedildi. Bu ölçümler ve daha sonra yapı­lan değerlendirmeler, hangi ilacın uygulandığını bilmeyen bir anestezist tarafından gerçekleştirildi. Bulgular: Gruplar arasında demografik veriler açısından fark bulunmadı (p>0.05). Her iki grupta da çalışma ilacı­nın uygulanmasıyla kalp atım hızı, sistolik kan basıncı, diyastolik kan basıncı ve ortalama kan basıncı düzeyle­rininin kontrol değerlerine göre azaldığını, bu azalmanın Grup E\' de daha belirgin olduğunu ve Grup L\' ye göre düşük bulundu. Grup L\' nin 1,5 ve 7. dakika SKB değerleri Grup E\' ye göre daha yüksek bulundu (p

Anahtar Kelimeler

Esmolol; lidokain; entübasyon; he­modinamik yanıt

Kaynakça

• Hamaya Y, Dohi S. Differences in cardiovascular re- sponse to airway stimulation at different sites and blockade of the responses by lidocaine. Anesthesiol- ogy 2008; 93:95-103.
• Kovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth 1996;8:63-79.
• Goyagi T, Tanaka M, Nishikawa T. Landiolol attenuates the cardiovascular response to tracheal intubation. J Anesth 2005;19:282-286.
• Bansal S, Pawar M. Haemodynamic responses to la- ryngoscopy and intubation in with pregnancy-induced hypertension; effect of intravenous esmolol with or without lidocaine. Int J Obstet Anesth 2002;11:4-8.
• Inoue S, Tanaka Y, Kawaguchi M, et al. The efficacy of landiolol for suppressing the hyperdynamic response following laryngoscopy and tracheal intubation: a sys- tematic review. Anaesth Intensive Care 2009;37:893- 902.
• Kurian SM, Evans R, Fernandes NO, et al. The effect of an infusion of esmolol on the incidence of myocardial ischaemia during tracheal extubation following coro- nary artery surgery. Anaesthesia 2001;56:1163-1168.
• Mikawa K, Nishina K, Maekawa N, et al. Comparison of nicardipine, diltiazem and verapamil for controlling the cardiovascular responses to tracheal intubation. Br J Anaesth 1996;76:221-226.
• Wiest DB, Haney JS. Clinical pharmacokinetics and therapeutic efficacy of esmolol. Clin Pharmacokinet 2012;51:347-356.
• Korpinen R, Simola M, Saarnivaara L. Effect of esmolol on the hemodynamic and electrocardiographic chang- es during laryngomicroscopy under propofolal fentanil anesthesia. Acta Anaesthesiol Belg 1998;49:123-32.
• Steven MH, Martin IG, Everard AD, et al. Which drug prevents tachycardia and hypertension associated with tracheal intubation: Lidocaine, fentanyl or esmo- lol. Anesth. Analg 1991;72:482-659.
• Keskin HE. Bilgin H. Laringoskopi, entübasyon ve eks- tübasyona bağlı hemodinamik yanıtın önlenmesinde esmolol ve lidokainin etkilerinin karşılaştırılması. Türk Anest Rean Der Dergisi 2005;33:463-470.
• Helfman SM, Gold MI, DE Lisser EA. Which drug pre- vents tachycardy and hypertension associated with tracheal intubaton: lidocaine, fentanyl or esmolol? Anesth Analg1991;72:482-486.
• Alexander R, Binns J, and Hetreed M. A controlled trial of the effects of esmolol on cardiac function Br J Anaesth 1994;72:594-595.
• Kindler CH, Schumacher PG, Schneider MC, et al. Effects of intravenous lidocaine and/or esmolol on hemodynamic responses to laryngoscopy and intu- bation: a double-blind, controlled clinical trial. J Clin Anesth 1996;8:491-496.
• Samaha T, Ravussin P, Claquin C, et al. [Prevention of increase of blood pressure and intracranial pres- sure during endotracheal intubation in neurosurgery: esmolol versus lidocaine]. Ann Fr Anesth Reanim 1996;15:36-40.
• Figueredo E, Garcia-Fuentes EM. Assessment of the efficacy of esmolol on the haemodynamic changes in- duced by laryngoscopy and tracheal intubation: a me- ta-analysis. Acta Anaesthesiol Scand 2001;45:1011- 1022.
• Hussain AM, Sultan ST. To compare the effectiveness of single bolus dose of esmolol or fentanyl in attenu- ating the haemodynamic responses during laryngos- copy and endotracheal intubation. J.Coll Physicians Surg Pak 2005;15:454-457.
• Sharma S, Ghani AA, Win N, et al. Comparison of two bolus doses of esmolol for attenuation of haemody- namic response to tracheal intubation. Med J Malay- sia 1995;50:372-376.
• Ebert TJ, Bernstein JS, Stowe DF, et al. Attenuation of hemodynamic responses to rapid sequence induction and intubation in healthy patients with a single bolus of esmolol. J Clin Anesth 1990;2:243-252.