Ahmad Afifi, Mohd Arshad
(2010)
Attenuation of haemodynamic response during intubation with glidescope® video laryngoscope using either lignocaine or magnesium; a randomized clinical study.
Masters thesis, Universiti Sains Malaysia.
Abstract
Intubation with Glidescope Videolaryngoscope (GSVL) has
been associated with longer period of pressor response. This study aimed to look at
haemodynamic parameters (SBP, DBP, HR, MAP) during laryngoscopy and intubation
using GSVL with either Lignocaine or Magnesium used to attenuate the pressor response.
Methodology: 82 patients planned for general anesthesia with endotracheal intubation
were recruited. They were blinded, and randomized into 2 groups; Lignocaine (A) and
Magnesium (B). The agents were given at 1.5mg/kg and 40mg/kg respectively in group A
and B, and each diluted into 20ml syringe and given IV over 5min before induction.
Inductions were standardized with IV Propofol 2mg/kg, IV Fentanyl Imcg/kg and IV
Rocuronium 1 mg/kg. A single intubator with experience in GSVL performed the
intubations. Haemodynamic parameters were collected at baseline, post induction, at
intubation, 1, 3, 5 and 10 minutes post intubation. The interaction of haemodynamic
parameters within and between groups were tested with repeated measure ANCOVA.
Result: There were significant interaction between time during intubation and estimated
marginal mean of DBP, MAP and HR in both groups (p<0.05). The changes in estimated
mean DBP and MAP were constantly less than baseline value post induction and
intubation. However the rise in HR at Imin postintubation in Magnesium group was 11%
above baseline and required 5 minutes to return to baseline (p<0.05). The interaction in
SBP is not significant (p>0.05).
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Conclusion: Magnesium at 40mg/kg is less effective than lignocaine in attenuating
pressor response to intubation with GSVL.
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