مقایسه اثر لیدوکائین وریدی ونرمال سالین با رمیفنتانیل بر پاسخهای همودینامیک در زمان بیداری از بیهوشی عمومی

Background and aimsWe have compared the effects of lidocaine, remifentanil and placebo on the hoemodynamicresponses to tracheal extubation.MethodsThis was a prospective, randomized clinical trial, double-blind study in 18 to 50 years old adultswith ASA I - II, undergoing an orthopedic surgery. Anesthesia was induced with fentanyl 2 μg/kgIV and propofol 1.5 mg/kg and atracurium 0.6 mg/kg, and maintained with propofol 100μg/kg/min and repeated doses of atracurium 0.2 mg/kg. Ten and 50 minutes before the end ofsurgery, propofol and fentanyl were discontinued respectively. At the end of surgery a bolusdose of Remifentanil 0.25 μg/kg or Lidocaine 1.5 mg/kg or 5 ml normal saline was given andtracheal extubation was performed after standard criteria acheivement. Arterial pressure andheart rate were recorded at the time of 1,5,10 intervals from the end of surgery.ResultsThere were statistically significant differences between the lidocaine and remifentanil groupwith respect to hemodynamic parameters (heart rate, diastolic blood pressure) at 5, 10 minintervals from the end of surgery. Systolic blood pressure at three times was significantlydifferent in three groups.ConclusionsRemifentanil is more effective than lidocaine on cardiovascular response control duringemergence from anesthesia and extubation.