scholarly journals Comparison of Intravenous Magnesium Sulphate and Lidocaine Effects on Attenuating Haemodynamic Variables to Laryngoscopy and Intubation in Patient Undergoing General Anesthesia

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Muhammad Azam ◽  
Muhammad Wasim Ali Amjad ◽  
Saadia Khaleeq ◽  
Naila Asad

Objective: To determine the effect of intravenous xylocaine and magnesium sulfate on attenuation of hemodynamic response to laryngoscopy and intubation in patients undergoing general anaesthesia. Methods: This was a randomized controlled study carried out at operation theaters of services hospital lahore after obtaining approval from IRB of hospital. The data was collected over period of six month from 20.05.2020 to 20.12.2020 through electronic databases. 60 patients were divided into two groups of 30 each by lottery method in this randomized control trial. Intravenous magnesium sulphate 30 mg/ kg diluted in 50 ml normal saline 15 min before induction was administered in M group and 50 ml normal saline given in L group. Induction was done with propofol 2 mg/ kg, followed by suxamethonium 2 mg/ kg. I/V lignocaine 1.5 mg/kg diluted in N/S (5ml) was given as bolus in L group and 5 ml N/S IV bolus in M group 1 minute before intubation. Laryngoscopy was performed and the trachea was intubated after 1 minute. HR, systolic (SBP), diastolic (DBP) and mean arterial pressures (MAP) were measured just before securing intravenous access, just before induction, after intubation and 1,3,5 min post intubation. Results: Mean age for both groups was 36.0±12.8 and 38.2±10.8. Mean HR was significantly different between two groups immediately after intubation (p=0.010), and at 1, 3 and 5 minutes also (p=0.004, p=0.018 and p=0.024) respectively. No significant difference was seen in systolic, diastolic and mean blood pressures at intubation, 1 minute, 3 minutes and 5 minutes after intubation among the groups (p>0.05). Conclusion: Both Magnesian Sulfate and lignocaine are effective in attenuating haemodynamic response to laryngoscopy and intubation but magnesium sulphate provides better efficacy in control of heart rate. Key Words: Haemodynamic response, laryngoscopy, Intubation, magnesium sulphate, lignocaine. How to cite: Azam M., Amjad A.W.M., A. Khaleeq S., Asad N. Comparison of Intravenous Magnesium Sulphate and Lidocaine effects on attenuating haemodynamic variables to laryngoscopy and intubation in patient undergoing general anesthesia. Esculapio 2021; 17(01):65-70 DOI

2019 ◽  
Vol 47 (12) ◽  
pp. 6254-6267
Author(s):  
Soo Kyung Lee ◽  
Mi Ae Jeong ◽  
Jeong Min Sung ◽  
Hyo Jin Yeon ◽  
Ji Hee Chang ◽  
...  

Background The induction of general anesthesia may cause hemodynamic instability. Remifentanil is often administered to suppress the hemodynamic response. We aimed to evaluate the effect of remifentanil infusion on the hemodynamic response to induction of anesthesia in hypertensive and normotensive patients. Methods Patients were divided into two groups: Group H (n = 102) were hypertensive patients and Group C (n = 107) were normotensive patients. During induction, all patients received 1 µg/kg of remifentanil as a loading dose over 2 minutes, followed by a continuous infusion at 0.05 µg/kg/minute. We analyzed the systolic, diastolic, and mean pressures and heart rate pre-induction, pre-intubation, immediately post-intubation, and at 2, 4, 6, 8, and 10 minutes after intubation. Results The systolic, diastolic, and mean pressures before induction were significantly higher in group H compared with group C, but there was no significant difference between the two groups immediately after intubation. Blood pressures immediately after intubation were similar to the pre-induction blood pressure. There was no significant difference in heart rate between the two groups at any time point. Conclusions Remifentanil infusion effectively attenuates the hemodynamic response to induction of general anesthesia in hypertensive and normotensive patients.


2019 ◽  
Vol 6 (3) ◽  
pp. 833
Author(s):  
Shahnaz Ahmad Sheikh ◽  
Aabid Hussain Mir ◽  
Abida Yousuf ◽  
Imtiaz Ahmad Naqash

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p<0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252465
Author(s):  
Abebaw Misganaw ◽  
Mulualem Sitote ◽  
Suliman Jemal ◽  
Eyayalem Melese ◽  
Metages Hune ◽  
...  

Background Laryngoscopy and endotracheal intubation are essential components of general anesthesia. But it is always associated with side effects called reflex cardiovascular responses. Many methods have been identified to attenuate these responses like intravenous lidocaine, deep inhalational anesthesia, vasodilators, intravenous magnesium sulphate even though therapeutic superiority remains understudied. Methods An institutional-based cohort study on 112 adult patients aged between 18–60 years was applied. 37 patients in the non-exposed group (Group N), 37 in the lidocaine group (Group L), and 38 in magnesium sulphate (Group M) were included. The hemodynamic parameters like heart rate, systolic, diastolic and mean arterial blood pressure at various time points up to 7 minutes post-intubation were recorded and the effect of both drugs to reduce hemodynamic responses was compared. Parametric data were analyzed using ANOVA and nonparametric data using the Kuruska-Wallis H rank test. P-value < 0.05 considered statistically significant. Results In all three groups, there was a statistically significant rise in heart rate and blood pressure from baseline. There was a statistically significant difference in mean heart rate throughout study minutes among the groups (p<0.001). However, there was no statistically significant difference in mean heart rate between Groups M and L at all post-intubation time intervals. In blood pressure at all three parameters there was statistically significant difference among groups at all-time points except no difference at 7th minutes in DBP. There was significantly lower blood pressure in group M compared to both groups. Conclusion In conclusion, prophylactic administration of magnesium sulphate and lidocaine was effective in attenuating hemodynamic responses to the stress effect of laryngoscopy and intubation. But based on our finding prophylaxis of magnesium sulphate is associated with a more favorable hemodynamic response.


2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia


2020 ◽  
Author(s):  
Hong Chen ◽  
Bin Wang ◽  
Qin Li ◽  
Juan Zhou ◽  
Rui Li ◽  
...  

Abstract Background: The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia.Methods: This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results: CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p<0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p<0.001). No differences were detected in Steward score out of PACU (p=0.213) and from the time of the end of operation to fully awake (p=0.417).Conclusion: Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia.Clinical Trial Registration: Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hong Chen ◽  
Bin Wang ◽  
Qin Li ◽  
Juan Zhou ◽  
Rui Li ◽  
...  

Abstract Background The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia. Methods This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p < 0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p < 0.001). No differences were detected in Steward score out of PACU (p = 0.213) and from the time of the end of operation to fully awake (p = 0.417). Conclusion Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia. Trial registration Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018.


2020 ◽  
Vol 5 (1) ◽  
pp. 185-190
Author(s):  
T. Padma ◽  
Raju B ◽  
Raviraj GS

Background: Postoperative sore throat (POST) is a well-recognized complication that remains unresolved in patients undergoing endotracheal intubation for general anaesthesia. The wide variation in these figures is presumably due to different skills and techniques among anesthetists and to differences between patients in the definition of sore throat. The main aim is to study the attenuating effect of Magnesium sulphate nebulization on the incidence of post-operative sore throat. Subjects and Methods: This is a prospective randomized clinical study. A total number of 100 patients of ASA grade 1 & 2, in the age group of 18 - 60 years. The study has been carried out at Sri Venkateswara Ram Narayana Ruia Government General Hospital, Sri Venkateswara Medical College, Tirupati, over a period of 12 months. Results: There was no significant difference among the groups in terms of age, gender and weight. Whereas Magnesium sulphate significantly lessens the POST during swallowing at 4th hour as compared to Normal saline (p< 0.05) and this statement can be attributed to any population. Conclusion:  Post-operative sore throat is one of the most common undesirable anesthesia-associated problems in the patients undergoing GA with an endotracheal tube for routine surgical cases for up to 24 h. Magnesium sulphate was significantly reduces the incidence of POST compared to Normal saline , and it is safe, simple and effective in reducing postoperative sore throat.


2008 ◽  
Vol 36 (6) ◽  
pp. 840-844 ◽  
Author(s):  
S. Narang ◽  
J. S. Dali ◽  
M. Agarwal ◽  
R. Garg

Several additives have been combined with local anaesthetics for intravenous regional anaesthesia to improve block quality, analgesia and to decrease tourniquet pain. Magnesium sulphate is one potential additive. This prospective, randomised, double-blinded study was conducted in 30 ASA physical status I or II patients undergoing upper limb surgery under tourniquet. In group L, patients received intravenous regional anaesthesia with lignocaine alone (9 ml of 2% lignocaine diluted with normal saline to total volume of 36 ml). Patients in group M received intravenous regional anaesthesia with lignocaine plus magnesium sulphate (6 ml of 25% magnesium sulphate plus 9 ml of 2% lignocaine diluted with normal saline to total volume of 36 ml). Assessment was by observing the response to injection of drug; sensory and motor block and tourniquet pain. The mean time of onset of sensory block was 12.40 and 3.47 minutes in groups L and M respectively (P <0.001). The average times of onset of motor block in groups L and M were 17 and six minutes respectively (P <0.001). Of the patients in group M, 66.7% reported moderate to severe pain while the drug was being injected, compared to 20% in group L (P=0.011). There was a statistically significant difference in visual analogue scale for tourniquet pain at 10 and 30 minutes after tourniquet inflation (lower in group M). These findings indicate that magnesium sulphate added as an adjuvant to lignocaine hastens the onset of sensory and motor block and decreases tourniquet pain. However, there is increased incidence of transient pain on injection if magnesium sulphate is added.


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