Effect of Midazolam, Fentanyl & I.V Lidocaine to Decrease the Stress Response of Laryngoscopy& ETT Intubation
Objective : The aim of the study to evaluate the role of fentanyl , midazolam & lidocaine in attenuation the hemodynamic response ( stress response ) of heart rate & blood pressure at induction of anesthesia , laryngoscopy & endotracheal intubation. Endotracheal intubation always associated with marked increases in heart rate and systemic blood pressure  .Marked increases in hemodynamic parameters occur after direct laryngoscopy & endotracheal intubation in patients with chronic hypertension. Patient & Methods : A double blind study was done in Aljamhory teaching hospital ,Mosul city ,Iraq .from (December 2012 - May 2014) . All the patients were in the age of 40 - 70 years and ASA II were all hypertensive & they were on routine antihypertensive agents. In this study a(87) patients ,males and females prepared for surgery needed endotracheal intubation ,group A (44 patients) underwent pre medication with fentanyl , midazolam & lidocaine and group B (43 patients) pre medicated with fentanyl & midazolam. Results : The average age in group A is 52.27 years and in group B is 50.46, there was no significant difference in the sex , weight or age distribution of patients. There was no significant difference statistically between the two groups ( P ˃ 0.05 ) in heart rate & blood pressure in pre induction , after induction & after endotracheal intubation. Conclusion : Because of stress response due to surgery & anesthesia , most of the patients’ needs anxiolytics , sedatives & pain killers as a pre medication , were as every patient complaining from hypertension ( ASA II ) needs anxiolytic , sedative & narcotic (pain killer) to overcomes the fluctuation in HR & BP .
The effect of Lidocaine with Fentanyl, or Midazolam on cardiovascular responses during Endotracheal intubation in hypertensive patients on Beta – blocker Dr. Kawa Dizaya , Dr. Alla M. Yousif, Dr. Muhamed Aydin .
Hemodynamic response to tracheal intubation via direct laryngoscopy and intubating laryngeal mask airway ( ilma ) in patients undergoing coronary artery bypass graft ( CABG ) ,Seyd Hedayat , Alla Hakhlagh , M0hamad Taghy Moeen Vaziri , Tooran Masoumi and Sanamja Vidanbardan .
KaHIm, eberHartIH , beHnke H , Sanger s , Schwarz u , Vogts , moosdorf r , Wulf H , geldner g : stress response to tracheal intubation in patients undergoing coronary artery surgery ; direct laryngoscopy versus an intubating laryngeal mask airway . j cardiothoracVascAnesth; 2004 , 18:275 – 280 .
Ronald D. Miller , MD ; MILLERS ANESTHESIA ; 2010 by Churchill Livingstone, an imprint of Elsevier inc .
John F . Butterworth IV , MD , David C. Mackey , MD , John D. Wasnick , MD , MPH , clinical Anesthesiology ,5th edition , 2013 .
Alan R. Aitken head , lain K. Moppet , Jonathan P. Thompson , Smith and Aitken heads Textbook of Anesthesia , 6th edition ,2013 .
Kovac, A. L. (1996) : controlling the hemodynamic response to laryngoscopy and endotracheal intubation . J. ClinAnesth.; 8:63 – 79 .
Yushi , U. A., Maiko, S., Hideyuki , H., Kazuhico , W. (2002) : Fentanyl attenuates the hemodynamic response to endotracheal intubation more than the response to laryngoscopy . Anesth.Analg. ;95:233 – 7 .
Sear , J. W. Jewkes , C. Tellez , J. C., Foex , P.(1994) : Does the choice of antihypertensive therapy influence hemodynamic responses to induction, laryngoscopy and intubation . BJA.;73:303 – 308 .
Mikawa, K., Nishina, K., Maekawa, N., Obara, H. (1996): comparison of nicardipine , diltiazem and verapamil for controlling the cardiovascular responses to tracheal intubation. Br J Anesth. Aug.; 77(2):296 – 297.
Figueredo, E., Garcia – Fuentes, E. M.(2001): Assessment of the efficacy of esmolol on the hemodynamic changes induced by laryngoscopy and tracheal intubation: A meta – analysis. Acta. Anesthesiol. Scand., Sep; 45(8):1011 – 22 .
Pharmacology for Anesthesia & Intensive care by ; Tom , E. PECK SUE HILL .
Andres Goth, ; medical pharmacology , principles & concepts ;2012 .
Comparison of Intubating Conditions using Fentanyl plus Propofol Versus Fentanyl plus Midazolam during Fiberoptic Laryngoscopy 10.7860/JCDR/2017/26479.10220
Dr. Kawa Dizaye *, Dr. Allaa M. Yousif, Dr. Muhamed Aydin; The effect of Lidocaine with Fentanyl, or Midazolam on cardiovascular responses during Endotracheal intubation in hypertensive patients on Beta-blocker, March 2011 - Volume 4, Issue 1.
- There are currently no refbacks.