Comparison of lidocaine and fentanyl for attenuation of cardiovascular response during laryngoscopy and tracheal intubation in cardiac surgery patients

摘要

Background : Prevention of stress injury by maintaining stable haemodynamic pressure is the corner stone of anaesthesia management. Lidocaine and fentanyl is the most common agent used for attenuation of presser response in healthy patients during intubation. Cardiac disease patient are more prone for stress injury. There was no previous study that compared their effect in cardiac surgery patient. Methodology : 60 patients were registered in this prospective, randomized double blind study. Group A received Lignocaine 1.5mg/kg i.v and group B received an additional dose of injection Fentanyl 3 mcg/kg i.v. 3 min prior to laryngoscopy. During induction various hemodynamic parameters was recorded during induction and 10 min intervals after tracheal intubation. Results: Both drug cause reduction in haemodynamic after induction of anaesthesia. At 1min after intubation the rise in pressure is more in lignocaine group as compared to fentanyl group. At 5min after intubation Group B showed a fall in pressure below base line whereas group A maintained above baseline. Both drug caused fall in pressure below baseline 10min after intubation. Both drug cause reduction heart rate (HR) after induction of anaesthesia. After intubation the rise in HR is more in lignocaine group but over a time showed a fall in HR below baseline in both group. Conclusion: Lignocaine (1.5 mg/kg) and Fentanyl (3 μg/kg) both attenuated the rise in HR, though fentanyl was better. Both drugs can be safely used for attenuation of stress response in cardiac disease patient undergoing elective cardiac surgery.