Assessment of the cardiovascular response of Propranolol and lignocaine to endotracheal intubation

Objective: assessment of the effect of propranolol and lignocaine on the cardiovascular response to endotracheal intubation, compared to placebo (IV normal saline). Methods: A case - control study included 60 subjects, and were divided into three groups (20 patients each), group A (control group, given normal saline), group B (given propranolol 0.01 mg/kg, slow IV injection for 4 minutes before laryngoscopy and endotracheal intubation). Group C (given lignocaine 1 mg/kg, slow IV injection for 4 minutes before laryngoscopy and endotracheal intubation). Results: For all the three groups, blood pressure decreased after induction, with mean changes in MAP from pre-induction to intubation was -34 (-36.6%), -21 (-18.6%), -22 (-24.2%) mmHg for group A, B, and C; respectively. Heart rate was significantly lower in group B compared to group A (from intubation till 5 minutes post-intubation), while group C was significantly lower compared to group A only at intubation and after 1 minute, from 2nd minute till 5 minutes no significant difference were observed. Change in HR from pre-induction to intubation was -40 (-47.1%), -19 (-20.7%), -25 (-28.1%) mmHg for group A, B, and C; respectively. Conclusion: No single drug can completely attenuate the cardiovascular response to endotracheal intubation; both lignocaine and propranolol have similar effect on attenuation this response but the adverse effects of lignocaine is less than that of propranolol.