scholarly journals A Comparative Study of Intravenous Nitroglycerin With or Without Intravenous Lignocaine for Attenuation of Stress Responses to Endotracheal Intubation

2018 ◽  
Vol 16 (2) ◽  
pp. 35-39
Author(s):  
Nabin Kumar Regmi ◽  
Grisuna Singh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Tracheal Intubation ◽  
Stress Responses ◽  
Age Groups ◽  
Rate Pressure Product ◽  
Double Blind Study ◽  
Double Blind ◽  
Group I

Background: Laryngoscopy and tracheal intubation lead to stress response which is characterized by transient rise in blood pressure and heart rate. This response is tolerated well in normal individuals but can lead to significant morbidity and mortality in patients with cardiovascular and cerebrovascular diseases. Search for the better drugs to suppress these responses is going on through decades.  Aim of Study: To compare the effects of IV nitroglycerin alone and in combination with IV lignocaine, on attenuation of stress response to end tracheal intubation.  Material and Methods: This is a randomized, double blind study conducted in 60patients admitted for operation at NGMCTH, between June 2018 to November 2018. Patients were of 16- 60 years age groups and belonging to ASA group I and II. Patients were divided into two groups: Group I IV Nitroglycerin 500 mcg+ NS 3 ml. (n=30) and Group IIIV Nitroglycerin 500 mcg+ IV Lignocaine 63 mg (n=30). Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Heart rate (HR) were measured and Rate Pressure Product (RPP) calculated. Results: Baseline values were comparable in both groups. Post Intubation, there was significant decrease in SBP at 0,1,3 and 5 minutes while DBP and MAP significantly decreased at 1, 3 and 5 minutes, in both groups. Significant tachycardia was noted in both groups at 0,1and 3 minutes, and RPP remained unchanged in both groups. Conclusion: Nitroglycerin significantly decreases blood pressure, prevents rise in RPP but does not attenuate heart rate after end tracheal intubation. There is no benefit of adding IV lignocaine to IV nitroglycerin for attenuation of stress response to end tracheal intubation.

scholarly journals Effect of Two Different Doses of Gabapentin on the Intraocular Pressure and Hemodynamic Stress Responses to Laryngoscopy and Tracheal Intubation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Amani A. Ali ◽  
Abeer M. Elnakera ◽  
Ahmed Samir
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Intraocular Pressure ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Stress Responses ◽  
Group I ◽  
Before And After ◽  
Different Doses

Background. The stress response to laryngoscopy and intubation causes an undesirable increase in heart rate, blood pressure, and intraocular pressure. This study was designed to compare the effect of two doses of gabapentin on the stress response to laryngoscopy and intubation. Patients and Methods. (ASA I and II) 60 patients, aged from 18 to 60 years undergoing elective eye surgery requiring endotracheal intubation, were randomly allocated into 3 groups, 20 patients each. 2 hours before the surgery, group I received oral placebo, and groups II and III received oral gabapentin 800 mg and 1200 mg, respectively. Heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP) were measured before and after induction of anesthesia, immediately after, 5 minutes, and 10 minutes after intubation. Results. Gabapentin 1200 mg prevented the increase in HR, MAP, and IOP, secondary to laryngoscopy and intubation, and kept them below the baseline till 10 minutes after intubation (), while with gabapentin 800 mg, the increase in HR, MAP, and IOP was nonsignificant () and returned to levels below the baseline at 5 and 10 minutes after intubation. Conclusion. Preoperative gabapentin 1200 mg effectively prevented the stress response to laryngoscopy and intubation; meanwhile, gabapentin 800 mg only prevented significant stress response.

scholarly journals Comparison of fentanyl and nalbuphine in obtunding stressor response to laryngoscopy and endotracheal intubation

2021 ◽  
Vol 8 (2) ◽  
pp. 294-301
Author(s):  
Milon V Mitragotri ◽  
Safiya I Sheikh ◽  
Roopa Sachinananda ◽  
Vikas Joshi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Respiratory Depression ◽  
Double Blind Study ◽  
Test Drug ◽  
Double Blind ◽  
Time Points ◽  
Hemodynamic Variables ◽  
High Doses

: Fentanyl has evinced its property of being a potent opioid and benumbing stress response to laryngoscopy and intubation (L&I). However respiratory depression and chest wall rigidity limits its utility at high doses. Nalbuphine, reported to have a ceiling effect for respiratory depression, can serve as an alternative. We studied and compared the efficacy of fentanyl and nalbuphine in preventing the rise in heart rate and blood pressure after L&I. A randomized double blind study was conducted in 60 subjects divided in two groups (Group F n=30 and Group N n=30) was done. Group F received 2µg kg fentanyl intravenously while group N received nalbuphine 0.2mg kg intravenously. Hemodynamic variables including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were measured at baseline and at intervals of five minutes of administering test drug, each minute up to five minutes after intubation, 10 minutes and 30 minutes after intubation. Complications, if any, were recorded after surgery. Change in HR, SBP, DBP and MAP between the two groups was compared using independent t-test. : The two drugs were equally effective in preventing HR rise at all-time points except after 30 minutes where fentanyl performed better. The change in SBP, DBP and MAP from baseline in both the groups was comparable.: Nalbuphine can serve as an alternative to fentanyl in obtunding stress response when given five minutes before intubation.

scholarly journals INTUBATION

2007 ◽  
Vol 14 (02) ◽  
pp. 466-470
Author(s):  
IFTIKHAR HUSSIAN ◽  
KHALID ZAEEM
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Body Weight ◽  
Stress Response ◽  
Bolus Dose ◽  
Double Blind Study ◽  
Double Blind ◽  
Back Ground ◽  
The Comparative Study

Back ground: Endo-tracheal intubation causes hypertensive stress response and increase in bloodpressure and heart rate. This increase in systolic blood pressure causes myocardial ischemia and dysrythmias invulnerable patient . Different drugs 1 are used intravenously to attenuate this hypertensive response during intubation.I compared glyceryltrinitrate with plain Lignocaine intravenous to obtund this hypertensive stress response. Materialand method. In a randomized, double blind study, 60 patients were selected for this study and divided into two equalgroups of I and II based on receiving intravenous glyceryltrinitate and plain lignocaine respectively. A bolus dose ofGlyceryltrinitrate (Nitronal) 200 μg, 20 seconds before intubation. And then titration at a rate of 2 μgm/kg/minute wasstarted. Group II was given plain lignocaine 1.5 mg/kg body weight. The comparative study was carried out to knowthe effectiveness of each drug to blunt the hypertensive stress response and Heart Rate Variability (HRV) duringintubation. Blood pressure and heart rate variability (HRV) immediately after intubation was assessed. Results: Bloodpressure fall was more marked in patient receiving Glyceryltrinitrate (Nitronal) then those of receiving plain Lignocaine,but heart rate variability (HRV) was greater in patient receiving Glyceryltrinitrate (Nitronal). Conclusion:Glyceryltrinitrate (Nitronal) is more effective than plain lignocaine in blunting the hypertensive stress response ofintubation .

scholarly journals A randomized trial to evaluate a modified tracheal catheter with upper and lower balloons for anesthetic administration: effect on the cardiovascular, stress response, and comfort in patients undergoing laparoscopic cholecystectomy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuenong Zhang ◽  
Zhiwen Zeng ◽  
Guangwen Xiao ◽  
Weiqiang Zhang ◽  
Weixiong Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Stress Response ◽  
Angiotensin Ii ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Group A ◽  
Endotracheal Anesthesia

Abstract Background We aimed to evaluate a modified endotracheal tube containing upper and lower balloons for anesthetic administration among patients undergoing laparoscopic cholecystectomy. Methods Ninety patients scheduled to undergo laparoscopic cholecystectomy were randomly allocated to 3 equal groups: group A (conventional tracheal intubation without endotracheal anesthesia); B (conventional tracheal intubation with endotracheal anesthesia); and C (tracheal intubation using a modified catheter under study). Blood pressure, heart rate, angiotensin II level, blood glucose level, airway pressure before anesthesia (T1) were measured immediately after intubation (T2), 5 min after intubation (T3), and immediately after extubation (T4). The post-extubation pain experienced was evaluated using the Wong-Baker Face Pain scale. Adverse reactions within 30 min after extubation were recorded. Results Systolic blood pressure, diastolic blood pressure, angiotensin II, and blood sugar level in group C at T2, T3 and T4, and heart rate at T2 and T4 were significantly lower than those in group A (P < 0.05); systolic blood pressure and blood sugar at T4, and angiotensin II levels at T2, T3, and T4 were significantly lower than those in group B (P < 0.05). Patients in group C reported the lowest post-extubation pain (P < 0.05 vs. Group A), and the lowest incidence of adverse events such as nausea, vomiting, and sore throat than that in groups A and B (P < 0.05). Conclusion The modified endotracheal anesthesia tube under study is effective in reducing cardiovascular and tracheal stress response, and increasing patient comfort, without inducing an increase in airway resistance. Trial registration The clinical trial was retrospectively registered at the Chinese Clinical Trial Registry with the Registration Number ChiCTR1900020832 at January 20th 2019.

Caffeine-Induced Changes in Cardiovascular Function during Resistance Training

2007 ◽  
Vol 17 (5) ◽  
pp. 468-477 ◽  
Author(s):  
Todd Anthony Astorino ◽  
Riana Lee Rohmann ◽  
Kelli Firth ◽  
Sondra Kelly
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Resistance Training ◽  
Bench Press ◽  
Cardiovascular Function ◽  
Strenuous Exercise ◽  
Rate Pressure Product ◽  
Double Blind ◽  
Warm Up ◽  
Leg Press

Caffeine (CAF) exerts a pressor effect both at rest and during exercise, as blood pressure is higher than with placebo. The effect of acute CAF ingestion combined with intense resistance training on cardiovascular function is unknown, however. The primary aim of the study was to examine changes in cardiovascular function after completion of fatiguing bench-press and leg-press exercise after CAF or placebo ingestion. Twenty-two resistance-trained men ingested CAF (6 mg/kg) or placebo 1 h pre exercise in a randomized, double-blind crossover design. They refrained from CAF intake and strenuous exercise 48 and 24 h pretrial, respectively. Heart rate and blood pressure were measured pre exercise. After a standardized warm-up, 1-repetition-maximum (1-RM) on the barbell bench press and leg press was tested. When it had been determined, a load equivalent to 60% of 1-RM was placed on the bar, and the subject completed repetitions to failure. Measurements of heart rate and blood pressure were immediately completed, and mean arterial pressure and rate-pressure product were calculated. Results showed significant (P < 0.05) increases in heart rate (+ 10 beats/min), systolic blood pressure (+ 8–10 mmHg), and rate-pressure product with acute CAF ingestion versus placebo. No change (P > 0.05) in diastolic blood pressure across time or treatment was shown. To prevent elevated blood pressure and potential enhanced risk of heart disease, CAF intake should be monitored in at-risk men who participate in resistance training.

scholarly journals Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery

2020 ◽  
Vol 23 (2) ◽  
pp. 9-13
Author(s):  
Sushila Lama Moktan ◽  
Manan Karki
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Perfusion Index ◽  
Non Invasive

Introduction: Laryngoscopy and intubation is always associated with a short term reflex sympathetic pressor response. The perfusion index is an indirect, non-invasive, and continuous measure of peripheral perfusion by pulse oximeter which can detect the stress response to intubation similar to heart rate, systolic blood pressure and diastolic blood pressure. Methods: This prospective observational study enrolled sixty-five normotensive patients of American society of anesthesiologists physical status grade I and II scheduled for elective surgery under general anaesthesia. Tracheal intubation was performed after induction with intravenous fentanyl, propofol and vecuronium. Heart rate, Systolic and Diastolic Blood Pressure and Perfusion Index were measured before induction of anesthesia, before intubation and one minute, three minutes, five minutes after the insertion of the endotracheal tube. Increase in heart rate by ?10 beats per minute, systolic and diastolic blood pressure by ?15 millimeters of mercury and decrease in Perfusion index ?10% after endotracheal intubation as compared to preintubationvalue were considered positive haemodynamic changes. Results: Endotracheal intubation produced a significant increase in heart rate and blood pressure whereas perfusion index decreased significantly. Our study showed that perfusion index response criterion achieved 97.7% (Confidence interval 97.58-97.86) sensitivity in detecting the stress response to insertion of endotracheal tube whereas systolic and diastolic blood pressure achieved sensitivity of 90% and 92% respectively. Conclusion: Perfusion Index is easier, reliable and non-invasive alternative to conventional haemodynamic criteria for detection of stress response to endotracheal intubation.

Attenuation of Cardiovascular Response During Laryngoscopy and Endotracheal Intubation by Using Pethidine with Lignocaine

1970 ◽  
Vol 6 (2) ◽  
pp. 40-43 ◽  
Author(s):  
MT Mollick ◽  
MD Hossain ◽  
NP Ali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Weight ◽  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Cardiovascular Response ◽  
Rate Pressure Product ◽  
Group I ◽  
Blood Pressures ◽  
Group Ii

A prospective comparative study was done on lignocaine versus lignocaine with pethidine to observe the effect on cardiovascular response to laryngoscopy and endotracheal intubation. One hundred such elective surgical patients of active age group (16 - 60 years) having American Society of Anaesthesiologist (ASA) physical status I & II irrespective of surgical procedure were randomly assigned to one of the two groups of 50 each. Group I received injection lignocaine 1 mg/kg intravenously 02 minutes before induction of general anaesthesia. Patients in group II received injection pethidine 1 mg/kg body weight and injection lignocaine 1 mg/kg body weight intravenously 02 minutes before induction of general anaesthesia. Haemodynamic parameter i.e. blood pressures (systolic blood pressure, diastolic blood pressure and mean blood pressure), heart rate, rate pressure product were monitored after 1st, 3rd, 5th minutes following intubation. There were statistically significant (p<0.001) increase in blood pressures, heart rate and rate pressure product in group I i.e. pretreatment with 1 mg/kg body weight intravenous lignocaine and remained so after 5 minutes. On the other hand there were no statistically significant (p>0.05) increase in heart rate, blood pressures and rate pressure product in group II, where pretreatment done with pethidine 1 mg/kg body weight with lignocaine 1 mg/kg body weight and the values returned control level before 5 minutes. The study showed that pethidine 1 mg/kg body weight with lignocaine 1 mg/kg body weight pretreatment suppresses the cardiovascular response due to laryngoscopy and intubation. Key words: Cardiovascular response; laryngoscopy; lignocaine with pethidine. DOI: 10.3329/jafmc.v6i2.7274JAFMC Bangladesh. Vol 6, No 2 (December) 2010 pp.40-43

scholarly journals A prospective randomised study comparing intravenous magnesium sulphate and sublingual nitroglycerine spray in attenuating haemodynamic responses to laryngoscopy and intubation

2018 ◽  
Vol 5 (2) ◽  
pp. 90 ◽  
Author(s):  
Deepti M. Kotwani ◽  
Manish B. Kotwani ◽  
Amit Hiwarkar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Stress Responses ◽  
Magnesium Sulphate ◽  
Study Drug ◽  
Intravenous Magnesium ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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<strong> </strong>(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.</p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions: </strong>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.</p><p class="abstract"> </p>

scholarly journals Hemodynamic response in laparoscopic cholecystectomy after magnesium sulphate versus clonidine administration

2018 ◽  
Vol 6 (10) ◽  
pp. 3239
Author(s):  
Vijaya P. Borkar Patil ◽  
Mayuri Ganeshrao Tambakhe ◽  
Sunil Shankarrao Lawhale ◽  
Jayshree J. Upadhye
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Magnesium Sulfate ◽  
Magnesium Sulphate ◽  
Hemodynamic Response ◽  
Double Blind Study ◽  
Double Blind ◽  
Vasopressin Release ◽  
Significant Difference ◽  
The Mean

Background: Magnesium and clonidine both inhibit catecholamine and vasopressin release. They also attenuate hemodynamic response to pneumoperitoneum.Methods: This randomized double-blind study was designed to assess which agent attenuates hemodynamic stress response to pneumoperitoneum better in 70 patients undergoing laparoscopic cholecystectomy.Results: After the administration of drug, heart rate in group M was mean 84.29 while in group C was mean 79.89. Thus, there was more fall in Heart rate in C group. After intubation, heart rate at 1min, 3 min, 5 min was 101.20, 96.69, 93.94 respectively in group M and in C group was 96.37, 85.83, 86.17 respectively with p values (0.12, 0.001, 0.008). After giving drug, there was fall in blood pressure in both groups but in C group, there was significant fall in systolic blood pressure. There was no significant difference in the mean diastolic BP in both the groups immediately at intubation (76.17±10.74 for group M and 78.86±10.48 for group C with p>0.05) as also at 3 min (63.29±8.76 for M group and 65.14±11.705 for clonidine with p>0.05) and 5 min (63.03±7.909 for magnesium sulphate and 67.69±13.588 for clonidine with p>0.05) following intubation. Thus, the rise in mean diastolic BP was statistically similar in both Group M and Group C. There was no significant difference in the mean for MAP in both the groups immediately at intubation (88.86±12.76 for magnesium sulphate and 91.74±11.59 for clonidine) as also at 3 min (73.17±10.019 for M and 75.80±12.849 for C group. But at 5 min (71.71±9.11 for magnesium sulphate and 77.66±13.715 for clonidine) following intubation with p<0.05 which is significant.Conclusions: Administration of magnesium sulfate or clonidine attenuates hemodynamic response to pneumoperitoneum. Although magnesium sulfate produces hemodynamic stability comparable to clonidine, clonidine blunts the hemodynamic response to pneumoperitoneum more effectively.

Sign in / Sign up

Export Citation Format

Share Document