Comparison of Hemodynamic Response to Laryngoscopy / Intubation: Intravenous Lidocaine vs Repeat Dose Propofol

Abstract

Objectives: The contrast of effectiveness of repeat dose propofol with lidocaine efficacy before laryngoscopy in maintaining stable hemodynamic(pulse and mean blood pressure)pressure values following endotracheal intubation. Study design and setting: Randomized controlled interventional(purposive sampling) study by the Anesthesia Department at Farooq Hospital Islamabad, ASMC (Rwp)from 21-06-2024 to 04-10-2024. Methodology: The study was authorised by the Research Committee; Akhtar Saeed Medical College, Rawalpindi on 14th June 2023 Sample size was calculated by sample size calculator(statistics kingdom) employing a normal distribution, with margin of error 0.04, confidence level of 0.80(z-score of 1.28) and standard deviation of 0.24, the sample size was calculated to be 60 total subjects. Random sampling was used and bunched in two groups using the lottery method; patients had co induction and inj. dexamethasone 4mg, propofol 1.5mg/kg, inj. cisatracurium 0.15mg/kg as muscle relaxant for intubation in both groups. In group A and B, patients also received 0.5mg/kg propofol thirty seconds and 1.5 mg/kg lidocaine three minutes before laryngoscopy respectively. Cardiovascular parameters, i.e. (pulse, blood pressure) were monitored. Paired sample T test employed with a confidence interval (of 95%)analysing heart rate and mean blood pressure values with determination of significant P-value greater than 0.05. SPSS v 26 was used. Results: In group-A, 90% of cases more stable heart rate was noted as compared to group-B with a value of (63.3%). No incidence of bradycardia was noted in group-A, whereas in group-B it was 6.7%. Concerning mean blood pressure, raised values were noted in 23.3% cases and 30% cases in Group A and B respectively and stable systolic blood pressure values were seen in 80% and 66.7% cases in Group A and B respectively. Conclusions: The propofol repeat dose before intubation showed stable hemodynamic (pulse and mean blood pressure) values as compared to lidocaine following laryngoscopy in general anaesthesia.