COMPARATIVE STUDY OF THE HEMODYNAMIC EFFECTS OF ESMOLOL AND LIDOCAINE IN ATTENUATION OF HAEMODYNAMIC RESPONSES TO TRACHEAL EXTUBATION IN NEUROSURGICAL PATIENTS.

Background: To reduce airway and circulatory responses during extubation, various pharmacological and non-pharmacological methods have been used such as opioids, inhalational agents, local anaesthetics, vasodilators, alpha blockers, beta blockers, and calcium channel blockers. Present study was aimed to compare the hemodynamic effects of esmolol and lidocaine in attenuation of haemodynamic responses to tracheal extubation in neurosurgical patients. Material and Methods: Present study was single centric, observational, prospective, comparative study, conducted in patients with ASA 1 & 2, undergoing neurosurgical procedure (elective and emergency) with invasive blood pressure monitoring. Patients were divided in two group as Group 1 (Esmolol, n=30) & Group 2 (Lignocaine, n=30). Results: No significant difference was seen in the age wise distribution, gender wise distribution, mean weight & ASA grade distribution of patients enrolled in both groups. No significant difference in heart rate was seen among patients in both the group at baseline and at pre reversal stage. Average heart rate was significantly higher among patients in lignocaine after pre reversal stage from min 1 to 15 min. No significant difference in SBP was seen among patients in both the group at baseline and at pre reversal stage. Average SBP was significantly higher among patients in lignocaine after pre reversal stage from min 1 to 15 min. Nausea - vomiting were the two most common side effect seen among patients in both the group. No significant difference was seen among the reported side effect. Majority of patients in both the group has no coughing at extubation. No significant difference in the quality of extubation was seen among patients in both group Conclusion: No difference in the side effect was seen among patients in both group & majority of patients has smooth extubation with no coughing episode. [ABSTRACT FROM AUTHOR]