Attenuation of sympathetic pressor responses to laryngoscopy and intubation in patients with preeclampsia: Comparison between IV lignocaine and IV lignocaine with labetalol

Abstract

Introduction: tracheal intubation and laryngoscopy are invariably associated with reflex sympathetic pressor responses resulting in elevated HR & BP. This may prove detrimental in preeclampsia patients. Objectives: To compare the efficacy of adding labetalol 0.5mg/kg IV to lignocaine 1.5mg/kg IV for attenuating increases in HR,SBP,DBP and MAP during laryngoscopy and intubation under general anaesthesia in parturients with preeclampsia posted for LSCS and to study the incident of any side effects. Materials and Methods: 60 patients with mild PIH presenting for LSCS, either elective or emergency, under GA were studied and randomly allocated to one of the two groups of 30 patients each. All patients were premedicated with inj glycopyrrolate 0.01mg/kg IV, inj fentanyl 1 µg/kg along with study drug labetalol 0.5mg/kg given 5minutes before laryngoscopy and intubation. Patients were induced with thiopentone 5mg/kg IV and succinylcholine 2mg/kg IV, preservative free lignocaine 1.5mg/kg IV given 2minutes before intubation. HR, SBP, DBP were recorded before and after intubation, at 1 st , 3rd, 5 th and 10 th minutes. Results: Rise in the HR,SBP,DBP,MAP were observed in both the groups at one minute following laryngoscopy and intubation and these responses persisted for about 3 minutes after which they returned towards basal values and below the baseline in case of group 1(labetalol with lignocaine) compared to group 2(lignocaine) in preeclampsia. Conclusions: Adding labetalol 0.5mg/kg IV to lignocaine 1.5mg/kg IV is effective in further attenuation of haemodynamic response to laryngoscopy and intubation in preeclampsia patients.