Advanced Biomedical Research
Comparison the Effects of Intraoperative Labetalol and Lidocaine on Postoperative Blood Pressure and Heart Rate in Brain Surgeries
Authors
1 Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
Abstract
Background: Long-term anesthesia applied in some operations, especially in neurosurgical operations leads to unwanted complications. This study aimed to compare the effect of intraoperative labetalol and lidocaine injection on the rate of changes in postoperative blood pressure and heart beat in patients undergoing brain operation. Materials and Methods: This is a simple double-blind randomized clinical trial study conducted in Al-Zahra and Kashani Hospitals on 90 patients' candidate for craniotomy operation with the age range of 18–65 years, Glasgow Coma Scale (GCS) ≥13 before anesthesia, physical class of American Society of Anesthesiologists I, II, insensitivity to labetalol who were divided into two groups of 45 individuals in the random allocation method. To start anesthesia, fentanil 1.5 mg per 1 kg of body weight, midazolam 5 mg, propofol 2 mg/kg and then, atracurium 0.15 mg/kg and lidocaine 1.5 mg/kg were used. The rate of patients' bucking and blood pressure were checked at GCS time after operation and in patients' recovery in terms of 0, 5, 10, 20 and 30 min after arrival in the recovery room and 1 h later. Results: There was no significant difference in terms of hemodynamic parameters during the period of operation and recovery and at the time of extubation and during the study, no case of bradicardia, hypotension, tachycardia or hypertension was observed in the patients of both groups. Conclusion: Using labetalol in craniotomy surgery is helpful for two main reasons that are the proper control of intraoperative and postoperative blood pressure and prevention of postoperative reactions, especially cough and if there is no contraindication for using it, it is recommended.
Keywords
| 1. |
Edward RW, Richards JR. An investigation into the quality of post operation status. Ann Med 2010;35:63-7.  |
| 2. |
Sou YZ. Common early complication in the extubation time. J Anesthesiol 2009; 31:52-4. |
| 3. |
Attari M, Talakoub R, Rahimzadeh B. Comparison of the Effects of Morphine and Diltiazem on Blood Pressure and Heart Rate during Craniotomy Surgeries. J Isfahan Med Sch 2016;33(364): 2239-46. |
| 4. |
Hartley M, Vaughan RS. Problems associated with tracheal extubation. Br J Anaesth 1993;71:561-8. [PUBMED] |
| 5. |
Cottrell JE, Young WL. Cottrell and Young's neuroanesthesia. Elsevier Health Sciences; 2016, p.129. |
| 6. |
MacCarthy EP, Bloomfield SS. Labetalol: A review of its pharmacology, pharmacokinetics, clinical uses and adverse effects. Pharmacotherapy. 1983;3(4):193-219. |
| 7. |
Chan WS, Koren G, Barrera M, Rezvani M, Knittel-Keren D, Nulman I. Neurocognitive development of children following in-utero exposure to labetalol for maternal hypertension: A cohort study using a prospectively collected database. Hypertens Pregnancy 2010;29:271-83. [PUBMED] |
| 8. |
Owens WB. Blood pressure control in acute cerebrovascular disease. J Clin Hypertens (Greenwich) 2011;13:205-11. [PUBMED] |
| 9. |
Miller RD. Miller's anesthesia. In: Gary RS, Chales BB, editors. Neyrosurgerical Anesthetics. 6th ed. Philadelphia: Elsevier; 2005. p. 572-95. |
| 10. |
Kross RA, Ferri E, Leung D, Pratila M, Broad C, Veronesi M, et al. Acomparative study between a calcium channel blocker (Nicardipine) and a combined alpha-beta-blocker (Labetalol) for the control of emergence hypertension during craniotomy for tumor surgery. Anesth Analg 2000;91:904-9. [PUBMED] |
| 11. |
Do HS, Kim SY, Heo SJ, Park SJ. The effect of intravenous labetalol administration on hemodynamic responses during desflurane inhalation. Korean J Anesthesiol 2012;62:245-50. [PUBMED] |
| 12. |
Luvisotto TL, Auer RN, Sutherland GR. The effect of mannitol on experimental cerebral ischemia, revisited. Neurosurgery 1996;38:131-8. [PUBMED] |
| 13. |
Messerer M, Daniel RT, Oddo M. Neuromonitoring after major neurosurgical procedures. MiWnerva Anestesiol 2012;78:810-22. |
| 14. |
Samaha T, Ravussin P, Claquin C, Ecoffey C. Prevention of increase of blood pressure and intracranial pressure during endotracheal intubation in neurosurgery: Esmolol versus lidocaine. Ann Fr Anesth Reanim 1996;15:36-40. [PUBMED] |
| 15. |
Salih F, Rosenthal C, Wolf S. Intracranial hypertension in various brain diseases – Specific therapy and outcome. Anasthesiol Intensivmed Notfallmed Schmerzther 2012;47:50-5. [PUBMED] |
| 16. |
Oxorn D, Knox JW, Hill J. Bolus doses of esmolol for the prevention of perioperative hypertension and tachycardia. Can J Anaesth 1990;37:206-9. [PUBMED] |
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