Main Article Content
Abstract
BACKGROUND
In this study, we wanted to compare the efficacy of two different doses of Labetalol for controlling the hemodynamic responses to laryngoscopy and tracheal intubation under the same anaesthetic techniques in controlled hypertensive patients.
METHODS
This was a hospital-based prospective, randomized, and double-blinded study conducted among 96 patients who presented for a pre-anaesthetic check-up to the Department of Anaesthesiology and Critical Care, at Gauhati Medical College and Hospital, over a period of 1 year from 1st September 2021 to 31st August 2022 after obtaining clearance from the institutional ethics committee, and written informed consent from the study participants.
RESULTS
Intragroup comparison of mean SBP in patients receiving IV Labetalol 0. 15 mg/Kg and IV Labetalol 0. 3mg/Kg was statistically significant. In an intragroup comparison of mean DBP in patients receiving IV Labetalol 0. 15 mg/Kg, it was significant at 5 and 10 mins. In a comparison of changes in DBP and MAP at various predetermined time intervals i. e., at intubation, it was statistically significant. In an intragroup comparison of mean RPP in in patients receiving IV Labetalol 0. 3mg/Kg in comparison to the baseline, it was significant at 10 mins.
CONCLUSIONS
Both doses of IV Labetalol (0. 15 mg/Kg and 0. 3 mg/Kg), given 5 mins before endotracheal intubation are effective in attenuating the hemodynamic response to laryngoscopy and intubation in controlled hypertensive patients. In comparison to the IV Labetalol dose of 0. 15 mg/Kg, attenuation of hemodynamic response to laryngoscopy and endotracheal intubation was more in IV Labetalol 0. 3 mg/Kg.
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References
- Kumar R, Gandhi R, Mallick I, et al. Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation with two different doses of Labetalol in hypertensive patients. Egyptian J Anaesth 2016;32(3):339-44.
- Chung KS, Sinatra RS, Chung JH. The effect of an intermediate dose of Labetalol on heart rate and blood pressure responses to laryngoscopy and intubation. J Clin Anesth 1992;4(1):11-5.
- Singh B, Saiyed A, Meena R, et al. A comparative study of Labetalol and fentanyl on the sympathomimetic response to laryngoscopy and intubation in vascular surgeries. Karnataka Anaesth J 2015;1(2):64-8.
- Bernstein JS, Ebert TJ, Stowe DF, et al. Partial attenuation of hemodynamic responses to rapid sequence induction and intubation with labetalol. J Clin Anesth 1989;1(6):444-51.
- Roberts CP, Greene LT, Meloche R, et al. Studies of anaesthesia in relation to hypertension-hemodynamic consequences of induction and endotracheal intubation. Br J Anaesth 1971;43:531-45.
- Amar D, Shamoon H, Frishman WH, et al. Effects of Labetalol on perioperative stress markers and isoflurane requirements. Br J Anaesth 1991;67(3):296-301.
- Kim SS, Kim JY, Lee JR, et al. The effects of verapamil, Labetalol, or fentanyl on hemodynamic responses to endotracheal intubation. Korean J Anesthesiol 1994;27(2):143-54.
- Kindler CH, Schumacher PG, Schneider MC. Effects of intravenous lidocaine and/or esmolol on hemodynamic responses to laryngoscopy and intubation: a double-blind, controlled clinical trial. J Clin Anesth 1996;8(6):491-6.
- Lakshmi BS, Sree MS, Prasad PK, et al. To evaluate effect of iv esmolol (1 mg/Kg) compared to i. v. Labetalol (0. 5 mg/Kg) in attenuating pressor response during laryngoscopy & intubation in general anesthesia. J Evol Med and Dental Sci 2014;3(35):9371-8.
- Leslie JB, Kalayjian RW, McLoughlin TM, et al. Attenuation of the hemodynamic responses to endotracheal intubation with preinduction intravenous Labetalol. J Clin Anesth 1989;1(3):194‑200.
- Ramanathan J, Sibai BM, Mabie WC, et al. The use of Labetalol for attenuation of hypertensive response to endotracheal intubation in preeclampsia. Am J Obstet Gynecol 1988;159:650‑4.
- Richards DA, Prichard BNC. Clinical pharmacology of Labetalol. Br J Clin Pharm 1979;8(Suppl 2):89S-93S.
- Singh SP, Quadi A, Malhotra P. Comparison of esmolol and Labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation. Saudi J Anaesth 2010;4(3):163-8.
- Scott DB. The use of Labetalol in anethesia. Br J Clin Pharmacol 1982;13(Suppl 1):133S-5.
- Inada E, Cullen DJ, Nemeskal AR, et al. Effect of Labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study. J Clin Anesth 1989;1(3):207-13.
- Swami NR, Badhe VK, Deshpande VV, et al. A comparison between intravenous metoprolol and Labetalol in prevention of cardiovascular stress response to laryngoscopy and intubation. Anaesth Pain & Intensive Care 2018;22(2):180-6.
References
Kumar R, Gandhi R, Mallick I, et al. Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation with two different doses of Labetalol in hypertensive patients. Egyptian J Anaesth 2016;32(3):339-44.
Chung KS, Sinatra RS, Chung JH. The effect of an intermediate dose of Labetalol on heart rate and blood pressure responses to laryngoscopy and intubation. J Clin Anesth 1992;4(1):11-5.
Singh B, Saiyed A, Meena R, et al. A comparative study of Labetalol and fentanyl on the sympathomimetic response to laryngoscopy and intubation in vascular surgeries. Karnataka Anaesth J 2015;1(2):64-8.
Bernstein JS, Ebert TJ, Stowe DF, et al. Partial attenuation of hemodynamic responses to rapid sequence induction and intubation with labetalol. J Clin Anesth 1989;1(6):444-51.
Roberts CP, Greene LT, Meloche R, et al. Studies of anaesthesia in relation to hypertension-hemodynamic consequences of induction and endotracheal intubation. Br J Anaesth 1971;43:531-45.
Amar D, Shamoon H, Frishman WH, et al. Effects of Labetalol on perioperative stress markers and isoflurane requirements. Br J Anaesth 1991;67(3):296-301.
Kim SS, Kim JY, Lee JR, et al. The effects of verapamil, Labetalol, or fentanyl on hemodynamic responses to endotracheal intubation. Korean J Anesthesiol 1994;27(2):143-54.
Kindler CH, Schumacher PG, Schneider MC. Effects of intravenous lidocaine and/or esmolol on hemodynamic responses to laryngoscopy and intubation: a double-blind, controlled clinical trial. J Clin Anesth 1996;8(6):491-6.
Lakshmi BS, Sree MS, Prasad PK, et al. To evaluate effect of iv esmolol (1 mg/Kg) compared to i. v. Labetalol (0. 5 mg/Kg) in attenuating pressor response during laryngoscopy & intubation in general anesthesia. J Evol Med and Dental Sci 2014;3(35):9371-8.
Leslie JB, Kalayjian RW, McLoughlin TM, et al. Attenuation of the hemodynamic responses to endotracheal intubation with preinduction intravenous Labetalol. J Clin Anesth 1989;1(3):194‑200.
Ramanathan J, Sibai BM, Mabie WC, et al. The use of Labetalol for attenuation of hypertensive response to endotracheal intubation in preeclampsia. Am J Obstet Gynecol 1988;159:650‑4.
Richards DA, Prichard BNC. Clinical pharmacology of Labetalol. Br J Clin Pharm 1979;8(Suppl 2):89S-93S.
Singh SP, Quadi A, Malhotra P. Comparison of esmolol and Labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation. Saudi J Anaesth 2010;4(3):163-8.
Scott DB. The use of Labetalol in anethesia. Br J Clin Pharmacol 1982;13(Suppl 1):133S-5.
Inada E, Cullen DJ, Nemeskal AR, et al. Effect of Labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study. J Clin Anesth 1989;1(3):207-13.
Swami NR, Badhe VK, Deshpande VV, et al. A comparison between intravenous metoprolol and Labetalol in prevention of cardiovascular stress response to laryngoscopy and intubation. Anaesth Pain & Intensive Care 2018;22(2):180-6.