مقايسه اثر سولفات منيزيم با فنتانيل و ليدوكايين بر تغييرات هموديناميك ناشي از لارنگوسكوپي و لوله گذاري در حين عمل جراحي عروق كرونر

A Comparison of Mg Sulfate, Fentanyl and Lidocain in Attenuating Hemodynamic Responses to Laryngoscopy in Patients with Coronary Artery Disease

Introduction: Laryngoscopy and endotracheal intubation result in severe hemodynamic changes in patients, which in CAD patients are more severe and they need more prompt controls. Objective: Considering the effects of magnesium in coronary vessels, myocardium, cardiac conduction system and whole body vasculature, our purpose in this research was to make a comparison of mg Sulfate, fentanyl and lidocain in attenuating hemodynamic responses to laryngoscopy in patients with coronary artery disease. Materials and Methods: We evaluated mg-sulfate ability in attenuating hemodynamic responses to laryngoscopy and intubation, in a double blind, prospective study with fentanyl and lidocaine which are used commonly in this regard. We randomly selected 60 patients and arranged them in 3 groups. All patients had EF more than 45%. In group A, 1.5mg/kg lidocaine, group B, 21.1g/kg fenanyl, and in group C, 30mg/kg mg sulfate were administered intravenously 3 minutes before laryngosocpy and mean arterial pressure (MAP) and heart rate (HR) were measured on arrival (base values), immediately before and after laryngoscopy and 1 min & 3 min after laryngosocpy. Induction of anesthesia in 3 groups was the same. Results: After laryngoscopy, increases in MAP and HR in group B and C (fentanyl and magnesium) were less than those in group A (p<0.05) with no significant difference between group B and C (p>0.05). Conclusion: Magnesium sulfate is completely preferable and superior to lidocain in attenuating hemodynamic responses to laryngoscopy and has equal efficacy and value with fentanyl.