Effect of labetalol and lignocaine on hemodynamic response to laryngoscopy and endotracheal intubation

Authors

DOI:

https://doi.org/10.15587/2519-4798.2023.285685

Keywords:

Labetalol, lignocaine, endotracheal intubation, heart rate, laryngoscopy, sympathomimetic reflexes, hemodynamic parameters, Mallampati airway assessment

Abstract

Direct laryngoscopy and endotracheal intubation is a noxious stimuli and induce sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life-threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients.

The aim is to study the effects of intravenous labetalol and lignocaine on haemodynamic responses to laryngoscopy and endotracheal intubation.

Materials and methods: It is a cross-sectional and randomized controlled study with two study groups was planned. 70 patients were randomly assigned to one of two groups: those receiving Labetalol 0.25 mg/kg (n=35) or those receiving lignocaine 1mg/kg (n=35). The parameters assessed are heart rate, systolic BP, diastolic BP and Mean arterial pressure. Baseline parameters were recorded at the time of induction, post-intubation immediately and 1, 3, 5, 10 minutes later.

Results: In the current study, at the time of induction, the mean heart rate was 65.97 ± 5.22 per min in group LB whereas the mean heart rate was 76.66 ± 8.49 per min in group LG which was statistically significant (P value <0.001). There was significantly reduced systolic blood pressure at 1min after intubation, 3min after intubation, 5min after intubation, and 10min after intubation in patients of group LB when compared with patients of group LG (P value <0.05). Significantly reduced diastolic blood pressure at 1 min after intubation, 3 min after intubation, 5 min after intubation, and 10 min after intubation in patients of group LB when compared with patients of group LG (P value <0.05).

Conclusions: It was concluded in the present study that intravenous labetalol of dosage 0.25 mg/kg before laryngoscopy and endotracheal intubation was efficient in attenuating the hemodynamic parameters

Author Biographies

Hanumanla Baby Rani, Gandhi Medical College Musheerabad

Professor and HOD

Department of Anesthesia

Chikkam Yamini, Gandhi Medical College Musheerabad

Post Graduate

Department of Anesthesia

References

  1. Sanjeev, O., Ratnani, E., Singh, A., Tripathi, M., Chourasia, H. (2017). A comparative study of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to laryngoscopy and endotracheal intubation. Anesthesia: Essays and Researches, 11 (3), 745–750. doi: https://doi.org/10.4103/aer.aer_9_17
  2. Kewalramani, A., Partani, S., Sharma, N. P., Sharma, V. (2016). Comparison of labetalol versus dexmedetomidine to assess the haemodynamic responses to laryngoscopy and intubation during induction of general anaesthesia – A prospective, randomized, controlled study. Indian Journal of Clinical Anaesthesia, 3, 512–517.
  3. Srivastava, V., Agrawal, S., Gautam, S. K., Ahmed, M., Sharma, S., Kumar, R. (2015). Comparative evaluation of esmolol and dexmedetomidine for attenuation of sympathomimetic response to laryngoscopy and intubation in neurosurgical patients. Journal of Anaesthesiology Clinical Pharmacology, 31 (2), 186–190. doi: https://doi.org/10.4103/0970-9185.155146
  4. Talke, P. (2017). The Effect of Tracheal Intubation-Induced Autonomic Response on Photoplethysmography. Anesthesiology Research and Practice, 2017, 1–5. doi: https://doi.org/10.1155/2017/7646541
  5. Lakhe, G., Pradhan, S., Dhakal, S. (2021). Hemodynamic Response to Laryngoscopy and Intubation Using McCoy Laryngoscope: A Descriptive Cross-sectional Study. Journal of Nepal Medical Association, 59 (238). doi: https://doi.org/10.31729/jnma.6752
  6. Kumar, R., Gandhi, R., Mallick, I., Wadhwa, R., Adlakha, N., Bose, M. (2016). Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation with two different doses of labetalol in hypertensive patients. Egyptian Journal of Anaesthesia, 32 (3), 339–344. doi: https://doi.org/10.1016/j.egja.2016.04.004
  7. Sanjeev, O., Ratnani, E., Singh, A., Tripathi, M., Chourasia, H. (2017). A comparative study of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to laryngoscopy and endotracheal intubation. Anesthesia: Essays and Researches, 11 (3), 745. doi: https://doi.org/10.4103/aer.aer_9_17
  8. Korukonda, V., Kaladhar, S. (2020). Attenuation of haemodynamic response to laryngoscopy and endotracheal intubation a comparative study between I.V. labetalol and I.V. lignocaine. Indian Journal of Clinical Anaesthesia, 7 (4), 676–680. doi: https://doi.org/10.18231/j.ijca.2020.121
  9. Kiran Kumar, Dr. H. (2019). Comparison of esmolol, labetalol and lignocaine for attenuation of sympathomimetic responses to laryngoscopy and endotracheal intubation. International Journal of Medical and Biomedical Studies, 3 (7). doi: https://doi.org/10.32553/ijmbs.v3i7.415
  10. Kumar, A., Mishra, P. K., Shukla, S. (2017). A randomized, controlled study to compare the effects of intravenous labetalol and esmolol on haemodynamic changes during laryngoscopy and intubation. International Journal of Research in Medical Sciences, 5 (9), 4003–4007. doi: https://doi.org/10.18203/2320-6012.ijrms20173971

Downloads

Published

2023-05-31

How to Cite

Baby Rani, H., & Yamini, C. (2023). Effect of labetalol and lignocaine on hemodynamic response to laryngoscopy and endotracheal intubation. ScienceRise: Medical Science, (3(54), 17–24. https://doi.org/10.15587/2519-4798.2023.285685

Issue

Section

Medical Science