COMPARISON OF ORAL IVABRADINE AND INTRAVENOUS LIGNOCAINE IN ATTENUATION OF HAEMODYNAMIC STRESS RESPONSE TO LARYNGOSCOPY AND INTUBATION: A RANDOMISED CONTROLLED STUDY
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Abstract
Background: Laryngoscopy and endotracheal intubation elicit a sympathetic surge, causing abrupt elevations in heart rate (HR) and blood pressure (BP).
Pharmacologic attenuation of this response is essential to prevent perioperative complications.
Aim: To compare the efficacy of oral ivabradine and intravenous lignocaine in attenuating haemodynamic responses to laryngoscopy and intubation in adult surgical patients.
Methods: A prospective, randomized controlled trial was conducted on 50 ASA I/II patients undergoing elective surgery under general anaesthesia. Group I received oral ivabradine 5 mg one hour before induction; Group L received IV lignocaine 1.5 mg/kg 90 seconds before laryngoscopy. HR, systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were recorded at baseline, post-induction, and at 1, 3, 5, and 10 minutes post-intubation.
Results: Ivabradine significantly attenuated the rise in HR and MAP post-intubation compared to lignocaine (p < 0.05). Though SBP and DBP changes were also better controlled with ivabradine, statistical significance was not consistent across all time points.
Conclusion: Oral ivabradine is more effective than IV lignocaine in attenuating the haemodynamic stress response to laryngoscopy and intubation, with minimal side effects and better HR control.
References
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3. Manjunath A, Kannan S, Rao P, Sharma V. Ivabradine as a Novel Agent for Perioperative Heart Rate Control: A Comparative Study. J Clin Anaesth. 2021;35(3):199–204. doi:10.1016/j.jclinane.2020.109876.
4. Lee A, Fan LT. Perioperative Use of Ivabradine in Non-cardiac Surgery: A Review of the Evidence. Anaesth Intensive Care. 2017;45(3):392–401. doi:10.1177/0310057X1704500314.
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Dr Dheeraj.R.Patel
Professor, Department of Anaesthesiology S.S. Institute of Medical Sciences And Research Centre, Davangere, karnataka
Dr Smitha Y
Associate Professor, Department of Anaesthesiology S.S. Institute of Medical Sciences And Research Centre, Davangere, Karnataka
Dr Vijaykumar C S
Post graduate, Department of Anesthesiology, S.S.Institute of Medical sciences and Research Centre, Davanagere, Karnataka