Abstract
Aim: A double blind, randomized, controlled, study was designed to compare the efficacy of single bolus doses of Fentanyl (2μg/kg) or Lignocaine (1.5 mg/kg) for attenuation of pressor response to laryngoscopy and endotracheal intubation (ETI). Methods: Ninety patients received either fentanyl or lignocaine or saline 5 minutes before intubation. Rest of the procedure was standardized. Results: The fentanyl group showed significantly lesser rise (5.46%) in HR compared to lignocaine (16.23%) (p=0.018) and Control group (43.68%) (p=0.000). The rise persisted for 2, 5 and 10 minutes in fentanyl, lignocaine & control groups respectively. The lignocaine group showed lesser rise in SBP (12.1%) compared to Control group (25.8%) (p=0.000) at intubation. The rise persisted for 3 minutes and 10 minutes in lignocaine and control groups respectively. The fentanyl group showed significant decrease in SBP after administration, which came back to normal at 1 to 3 minutes following intubation and again decreased 4 minutes after intubation. In the control group 50% of the patients had hypertension and 80% had tachycardia by definition, while no adverse effects were noted in lignocaine and fentanyl groups. Conclusion:Lignocaine and fentanyl both attenuated the rise in pulse rate, though fentanyl was better. Lignocaine attenuated the rise in blood pressure with intubation whereas fentanyl prevented it totally.
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