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Showing 2 results for Endotracheal Intubation
Effect of low-dose ketamine versus lidocaine on hemodynamic response to endotracheal intubation in general anesthesia: a prospective, triple-blinded, randomized controlled trial
Behzad Nazemroaya, Hosein Mahjobipoor , Elham Saberi,
Volume 81, Issue 3 (6-2023)
Abstract
Background: A smooth endotracheal intubation minimizes hemodynamic changes. We assessed the effect of ketamine and lidocaine on Diastolic blood pressure (DBP) Systolic blood pressure (SBP), heart rate (HR), Mean arterial pressure (MAP) and, oxygen saturation (SpO2) changes after endotracheal intubation compared to a control group.
Methods: In this randomized, triple-blind clinical trial (IRCT20200825048515N56) approved by the Medical Ethics Committee of the Isfahan University of Medical Sciences (IR.MUI.MED.REC.1400.721) 90 patients aged 18-65 years as candidates for surgery under general anesthesia at Alzahra Hospital in Isfahan were included between December 2022 and February 2023. They were randomly allocated to the ketamine hydrochloride (ketamine) (0.5 mg/kg), lidocaine hydrochloride 2% (Lignodic)          (0.5 mg/kg), and control groups. The subjects, age, height, weight, gender, Body mass index (BMI) and clinical information, such as mean blood pressure, HR, SBP, DBP, MAP, and, oxygen saturation 1, 3, 5 and 10 minutes following endotracheal intubation, recovery stay and, extubation time were noted and analyzed by repeated measure analysis using SPSS version 28. The significance level in all analyses was considered less than 0.05.
Results: Ninety candidates for electroconvulsive therapy (ECT) were randomly assigned to three groups of 30: one group receiving lidocaine hydrochloride, one receiving ketamine hydrochloride, and the other a control group. Overall, 60 cases (66.7%) were male and 30 cases (33.3%) were female.
Both lidocaine and ketamine effectively reduce hemodynamic changes during endotracheal intubation, but lidocaine potentially has greater benefits in terms of improving oxygenation and reducing heart rate variability, as well as reducing recovery time during anesthesia. No significant difference was detected between the two studied groups regarding diastolic blood pressure, systolic blood pressure, heart rate, mean arterial pressure changes, recovery stay, extubation time, and laryngoscopy grade.
Conclusion: Based on the findings in this study, lidocaine offered more desirable hemodynamic stability than ketamine and resulted in fewer hemodynamic disturbances. Also, in the case of persistent hypertension or tachycardia. This was not observed in any of the groups.

Comparing the rate of complications of sore throat and hoarseness caused by ETI support method with LMA method in surgical patients under general anesthesia
Farzaneh Boluki Moghaddam , Zhaleh Yousefi, Ali Baghery Hagh , Masoud Latifipour, Mahdi Raei,
Volume 81, Issue 3 (6-2023)
Abstract
Background: Respiratory support during the patient's anesthesia is done in different ways, such as endotracheal intubation and laryngeal mask. Endotracheal intubation is inevitably used for respiratory support in general anesthesia patients. The use of alternative methods for respiratory support during the process of general anesthesia is one of the most significant ways to control anesthesia complications. The laryngeal mask is placed around the larynx to allow spontaneous and controlled ventilation. Both of the respiratory support methods can cause complications. The purpose of this study is to compare the side effects of sore throat and hoarseness caused by two methods in surgical patients.
Methods: This study was conducted in the period from September to November 2022 on patients who were referred and underwent surgery at Baqiyatallah Hospital. The study is a cohort study that was conducted retrospectively on 60 patients who underwent any surgery with two methods of anesthesia by ETI and LMA. In order to evaluate hoarseness, the standard Voice Handicap Index (VHI-10) questionnaire was used. In order to evaluate the complication of sore throat caused by the respiratory support method, a 4-point pain checklist was used for 24 hours and 14 days after the surgery.
Results: The findings of our study showed that the average amount of sore throat 24 hours after surgery in the LMA and ETI groups was 2.13 and 2.2, respectively, and these values 14 days later were 1.17 and 1.07, respectively. The average level of hoarseness in the 24 hours after surgery in LMA and ETI groups was 2.66 and 3.13, respectively. The statistical comparison of the severity of side effects between the two groups showed that in the LMA method, the amount of sore throat and hoarseness is less than the ETI method, although this reduction does not have a significant difference.
Conclusion: The results of this study showed that the rate of complications of sore throat and hoarseness in the laryngeal mask group is reduced compared to the endotracheal intubation group, although this difference is not significant.

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