يوجد فقط 14 صفحة متاحة للعرض العام
The pressor response, which is a part of huge spectrum of stress response during laryngoscopy and intubation, is due to sympathoadrenal activity as evidenced by increased heart
rate (HR), blood pressure, and serum catecholamine concentrations.
During general anesthesia, airway control is generally provided by endotracheal intubation. Laryngoscopy prior to intubation and intubation in itself produce a significant hemodynamic stress in the form of tachycardia and hypertension, these hemodynamic changes are usually transient, variable, and unpredictable.
These changes may be of no consequence in healthy individuals, but they may be hazardous in patients with hypertension, myocardial ischemia, cerebrovascular diseases, and those with increased intraocular pressures.
Various drugs and techniques have been used from time to time for attenuating the stress response including opioids lidocaine beta blockers calcium channel blockers vasodilators and α2 agonists. However, no modality was devoid of drawbacks and limitations and the hunt for ideal drug continues.
Lornoxicam is a nonsteroidal anti-inflammatory drug (NSAID) with potent analgesic and anti-inflammatory activity that belong to oxicam group and acts by inhibiting cyclo-oxygenase 1 and 2 (COX-1 and COX-2).
Recently, many studies have proved its efficacy to attenuate the pressor response. We undertook this study to investigate the efficacy of lornoxicam in attenuating hemodynamic response to laryngoscopy and intubation in comparison with fentanyl.
The study was performed upon 94 patients, aging 18-50 years, and were divided into two groups.
group L: 47 patients who received lornoxicam 16mg, 3-4 minutes prior to induction of anesthesia
group F: 47 patients who received fentanyl 2 μg/kg, 3-4 minutes prior to induction of anesthesia
For each patient, the following data were collected: age, sex, body mass index, ASA classification, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, rate pressure product and blood glucose level before induction, during intubation and till 10 minutes after intubation.
The results showed that lornoxicam successfully attenuated the pressor response to a great extent, however using fentanyl results in a better hemodynamic stability over a longer periods of time and showed a better efficacy than lornoxicam