Effects of lidocaine versus fentanyl on attenuation of hemodynamic responses to extubation after ear, nose and throat surgery in a resource limited setting: A prospective observational study

Abstract

BackgroundTracheal extubation, the purposeful removal of the endotracheal tube from the trachea, can be associated with detrimental hemodynamic and airway responses. Lidocaine and fentanyl are known to suppress hemodynamic responses to extubation during Ear, nose, and throat surgeries. Smooth tracheal extubation is important after Ear, nose, and throat surgeries. ObjectiveTo compare the effects of lidocaine versus fentanyl on attenuation of hemodynamic responses to extubation after ear, nose and throat surgery in a resource limited setting from January 01, 2018 to March 30, 2018. MethodsThis is a prospective cohort study recruits 74 American Society of Anesthesiologist class I and II, age between 18 and 60 patients who underwent Ear, Nose, and Throat surgeries. Unpaired T test was used to compare the mean heart rate and arterial blood pressure between lidocaine and fentanyl groups. Mann Whitney U Test was used for distribution free data. Association of categorical independent variables between two groups was analyzed using Chi Square or fisher exact test. P-values < 0.05 were considered as statistically significant with a power of 80%. ResultsThe demographic and clinical characteristics were comparable between groups. The pulse rate and mean arterial blood pressure were statistically significantly lower in fentanyl group at 1, 5, and 10 min after extubation with p values < 0.05. There was no statistically significant difference between two groups in decreasing the incidence of coughing in the Peri-extubation period with a p value of 0.857. ConclusionThe findings of our study demonstrate that fentanyl 1 μg/kg IV, administered 10 min before end of operation might be effective in attenuating hemodynamic response to tracheal extubation compared with lidocaine 1.5 mg/kg IV in patients underwent ENT surgeries.