Effect of Midazolam, Fentanyl & I.V Lidocaine to Decrease the Stress Response of Laryngoscopy& ETT Intubation

Radhwan H. Alkhashab, Saad A. Hussein, Wajeda M. Othman


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 [1] .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 .


stress response; premedication; midazolam; fentanyl; lidocaine.

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