Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalato-pharyngoplasty

Abstract

Objective To evaluate the effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty. Methods Sixty patients were randomly divided into 4 groups: In the control group patients were given saline; in the lidocaine group patients were given 1.0 mg/kg lidocaine; in the diltiazem group patients were given 0.2 mg/kg diltiazem; and in the lidocaine plus diltiazem group patients were given 1.0 mg/kg lidocaine and 0.2 mg/kg diltiazem. These drugs were given 2 min before tracheal extubation. Values for SBP, DBP, and HR were recorded, on arriving at the operating room, immediately at the end of the surgery, at the time of injection of the study drugs, at tracheal extubation, at 1 min and 5 min after extubation. The quality of extubation according to the Sebel's grading scale were compared among the 4 groups. Results During extubation in the control group HR, SBP and DBF increased significantly when compared to baseline levels. Both lidocaine (1.0 mg/kg) and diltiazem (0.2 mg/kg) successfully alleviated these increases. The suppressive effect of diltiazem was greater than that of lidocaine. The combinative use of the two drugs minimized the increases. The administration of lidocaine significantly suppressed bucking or coughing compared with the other groups. Conclusions The pressor responses and tachycardia occurring in patients with uvulopalatopharyngoplasty during emergence from anesthesia and tracheal extubation, can be easily blocked by a bolus dose of 1.0 mg/kg lidocaine, 0.2 mg/kg diltiazem or the combinative use of the two drugs. And the concurrent use of lidocaine and diltiazem alleviated the hemodynamic changes more obviously.