Abstract No.: ABS0807 : Effects of intravenous Lignocaine infusion on Sevoflurane consumption in inhalation maintained anaesthesia by monitoring entropy: A randomised controlled study

Abstract

Background & Aims:The present study aimed to study the effect of intravenous Lignocaine infusion on Sevoflurane consumption required to maintain entropy between40 and 60 during anesthesia maintenance in humans. Pain scores using Numeric rating score (NRS) scale and incidence of post-operative nausea and vomiting were assessed postoperatively.Methods:The present study included 52 patients of either sex, of American Society of Anesthesiologists (ASA) grade I and II; aged between 18-70 years undergoing surgeries of >2 hours under general anaesthesia. Patients were randomly allocated into two groups using computer generated random number table into Lignocaine group, where lignocaine infusion was used and Control group, where equal volume of saline was infused. Anaesthesia regimens in both groups were standardised. Patient’s haemodynamics were monitored. Intraoperative Sevoflurane consumption (Value obtained from GE Avance CS2 machine) was noted at the end of surgery. Pain scores using NRS scale and postoperative nausea and vomiting incidence were assessed postoperatively.GroupMean±SD P PLSFAge49.62±14.554.7±11.380.19Bloodloss553.33±333.2545±466.160.937MAP185.9±16.5585.87±16.460.994HR 172.97±17.0772.23±12.020.848MAP3081.7±9.8585.27±16.870.322HR 3071.53±12.0268.47±13.090.348MAP6081.63±10.8188.07±12.470.037HR6071.1±13.0369.83±11.910.696MAP9081.07±14.7786.23±12.070.143HR9072.6±14.7170.1±13.230.492MAP12079.1±11.2185.87±10.830.021HR12070.83±15.4668.8±11.990.571MAP15079.93±9.0583.87±14.850.22HR15072±17.0470.63±13.810.734MAP18083.1±9.482.93±13.520.956HR18074.07±14.5272.83±12.390.725MAP21079.88±9.1985.21±150.144HR21076.25±16.2573±11.510.428MAP24085.41±14.0483.75±14.530.74HR24070.82±18.0377.56±15.980.266MAP27079.47±12.8183.4±14.030.486HR27071.93±16.8873.8±12.440.753MAP30079.1±15.5780.83±11.030.799HR30074.9±22.7278.33±14.990.722MAP33081.86±11.6474±5.230.16HR33076.14±21.2176.75±10.90.951MAP36078.33±9.8770±00.541HR36064±380±00.044ABG1pH7.38±0.057.37±0.030.578ABG2pH7.36±0.057.34±0.060.085@1pCo239.39±4.2439.63±5.310.852@2pCo240.18±4.2641.86±7.170.275@1pO2175.86±63.03178.67±68.030.869@2pO2204.57±43.82188.1±48.910.175@1Na134±4.11135.8±4.110.095@2Na135.07±2.42136.1±40.232@1K3.74±0.333.77±0.410.758@2K3.82±0.343.94±0.570.326@1Ca1.14±0.151.15±0.170.294@2Ca1.03±0.11.14±0.06<0.001@1Cl107.71±4.8109.27±3.150.155@2Cl107.17±3.68109.9±3.720.006@1Hb11.23±1.7110.82±2.290.431@2Hb10.17±1.7110.07±2.080.834@1glu132.48±42.14142.96±39.770.373@2glu157.23±38.88159.36±32.710.838@1HCo323.23±2.4522.64±3.350.463@2HCo322.33±3.0221.49±2.720.28@1BE-1.56±2.87-1.71±2.870.857@2BE-2.53±3.31-3.08±2.010.481Results:There was a statistically significant difference in hourly Sevoflurane consumption with reduced hourly consumption inLignocaine group, (P=0.03). There was no statistically significant difference in the total amount of sevoflurane consumption between the two groups, (p=0.52). The lignocaine group had lower pain score than control group 45min post extubation(P=0.04) and 1 day post surgery (P=0.01), with no significant difference in the incidence of post-operative nausea and vomiting.VariablesLignocaine GroupControl Group P Mean Sevoflurane Consumption (Per Hour) ml n(Per Hour) ml14±316±50.03Conclusion:Perioperative lignocaine infusion significantly reduces hourly Sevoflurane consumption in inhalation maintained anaesthesia. Perioperative lignocaine infusion causes significant reduction in pain scores but no difference in incidence of PONV. Lignocaine infusion is safe and further studies may provide a strong evidence for routine use of perioperative lignocaine.