A Study of Effect of Intravenous Magnesium Sulphate with Lignocaine and Intravenous Clonidine with Lignocaine on Blood Pressure in Response to Laryngoscopy and Tracheal Intubation during General Anaesthesia

Background: Laryngoscopy and tracheal Intubation are invariably associated with certain stress responses due to the sympatho-adrenal stimulation. These cardiovascular and neurohumoral alterations may directly affect the physiology and increase the risk. So far, various drugs have been tried but none has been considered ideal for blunting this presser response. We therefore, planned this comparative study to evaluate and compare the efficacy of intravenous magnesium sulphate (30 mg/kg) versus sublingual nitroglycerine spray (0.4 mg/spray) in attenuating the presser response to Laryngoscopy and Tracheal Intubation.Methods: Fifty patients, aged 15–50 years, scheduled for elective surgery under general anaesthesia, were randomly assigned to one of the two groups of 25 each, Group A (magnesium group) and Group B (nitroglycerine group). Study drug was given 90-120 seconds before tracheal intubation. Heart rate, Systolic blood pressure and Rate pressure product were recorded at different intervals after administering the study drug till 3 minutes after intubation.Results: Mean heart rate was significantly higher from the baseline at all times after administering the study drug in both the groups. Increase in systolic blood pressure as a presser response was limited to 7.25% in Group A and 5.83% in Group B from the baseline after tracheal intubation. There was relative hypotension after administration of the study drug in both the groups.Conclusions: Intravenous magnesium or sublingual nitroglycerine pre-treatment is found to be effective in attenuating the presser response to laryngoscopy and intubation. These drugs may lead to rise in HR but it is transient and dose dependent. However, both the drugs can significantly control the hypertensive response after laryngoscopy and intubation.

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A Double Blind Comparative Study of Efficacy of Intravenous Magnesium Sulphate with Lignocaine and Intravenous Clonidine with Lignocaine in Attenuating Hemodynamic Response to Laryngoscopy and Tracheal Intubation during General Anaesthesia

Indian Journal of Clinical Anaesthesia ◽

10.5958/2394-4994.2015.00042.6 ◽

2015 ◽

Vol 2 (4) ◽

pp. 269

Author(s):

H Anuradha ◽

Siddharam Jamagond ◽

K Ramesh

Keyword(s):

Tracheal Intubation ◽

Comparative Study ◽

General Anaesthesia ◽

Magnesium Sulphate ◽

Hemodynamic Response ◽

Double Blind ◽

Intravenous Magnesium

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Assessing the validity of a linear inflation method in noninvasive blood pressure monitoring during the induction period of general anaesthesia

Journal of Perioperative Practice ◽

10.1177/1750458920957917 ◽

2020 ◽

pp. 175045892095791

Author(s):

Ken-ichiro Kikuchi ◽

Naoyuki Hirata ◽

Yusuke Yoshikawa ◽

Michiaki Yamakage

Keyword(s):

Blood Pressure ◽

Tracheal Intubation ◽

Induction Period ◽

General Anaesthesia ◽

Blood Pressure Variability ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Noninvasive Blood Pressure ◽

Rapid Changes ◽

Haemodynamic Changes

Inflationary noninvasive blood pressure (iNIBP) monitoring can determine BP in a shorter time compared to conventional deflationary NIBP (dNIBP) monitoring. We assessed the efficacy of iNIBP monitoring during induction of general anaesthesia and tracheal intubation, which can cause rapid changes in haemodynamics. Our study included 14 surgery patients receiving tracheal intubation under general anaesthesia. Blood pressure was continuously measured using iNIBP monitoring. We recorded the percentage of successful iNIBP monitoring (measurements made without switching to dNIBP mode) during anaesthesia induction. We obtained 326 BP-measurements from 14 patients. The iNIPB mode was able to perform 90.9% of the measurements during the induction of general anaesthesia. iNIBP could determine BP even during periods of high blood pressure variability (31.6% [interquartile range; 22–40]). Our results validate the utility of iNIBP monitoring during the induction period of general anaesthesia, despite the rapid haemodynamic changes.

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A COMPARATIVE STUDY OF INFUSION DEXMEDETOMIDINE AND INFUSION MAGNESIUM SULPHATE ON ATTENUATION OF BLOOD PRESSURE SURGE IN LAPAROSCOPIC SURGERY UNDER GENERAL ANAESTHESIA

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2019/373 ◽

2019 ◽

Vol 8 (21) ◽

pp. 1695-1699

Author(s):

Suchismita Mallick ◽

Sarbari Sawika ◽

Siddhartha Chakraborty ◽

Subhasish Ghosh ◽

Rajat Choudhuri

Keyword(s):

Blood Pressure ◽

Laparoscopic Surgery ◽

Comparative Study ◽

General Anaesthesia ◽

Magnesium Sulphate ◽

Pressure Surge

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Evaluation of Two Different Doses of Pre-Emptive Intravenous Magnesium Sulphate as Post- Operative Adjunct Analgesia after Gynaecological Surgery

Medicine & Health ◽

10.17576/mh.2020.1502.16 ◽

2020 ◽

Vol 15 (2) ◽

pp. 164-174

Author(s):

Joanna Ooi Su Min ◽

Keyword(s):

Blood Pressure ◽

Side Effects ◽

Pain Score ◽

Magnesium Sulphate ◽

Gynaecological Surgery ◽

Patient Controlled Analgesia ◽

Analgesic Effects ◽

Intravenous Magnesium ◽

Group I ◽

Different Doses

This study compared the analgesic effects of pre-emptive intravenous magnesium sulphate of different dosages in patients undergoing lower abdominal gynaecological surgery. Fifty-six patients with Body Mass Index (BMI) <35 kg/m2 who underwent lower abdominal gynaecological surgery were randomly recruited into two groups. Group I received one ampoule (2.47 g) of magnesium sulphate and Group II received 50 mg/kg magnesium sulphate (based on body weight), pre-operatively. Pain score and patient controlled analgesia (PCA) morphine requirement were compared at 30 minutes, 12 hours and 24 hours post-operatively. The pain score was comparable at all intervals between the two groups (30 minutes, p = 0.450; 12 hours, p = 0.402; and 24 hours, p = 1.000). Post-operative PCA morphine requirement was not statistically significant between the two groups at 30 minutes, 12 hours, and 24 hours (2.7 vs 2.4 mg, p = 0.545; 12.5 vs 9.8 mg, p = 0.154; 7.7 vs 6.4 mg, p = 0.323). The side-effects of magnesium sulphate on blood pressure, heart rate and sedation were not statistically significant between the two groups. In conclusion, the analgesic effects of pre-emptively administered intravenous MgSO4 of 2.47 g (one ampule) was comparable to 50 mg/kg in patients with BMI less than 35 kg/m2 following lower abdominal gynaecological surgery under general anaesthesia with negligible side effects.

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