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Hemodynamic and cough response to extubation can
result in raised heart rate, blood pressures and intracavitary pressures which could be detrimental in
high-risk patients. The aim of our study was to estimate the difference in hemodynamic and cough
response to orotracheal tube extubation with saline (control group), I.V lignocaine 0.5mg/kg and I.V
lignocaine 1mg/kg and to evaluate the comparative efficacy between the groups. METHODS: In our
clinical prospective descriptive double blind study 90 patients of either sex scheduled for elective
surgical procedures requiring orotracheal intubation, who met inclusion criteria, were considered.
They were randomly divided into three groups of 30 each, Group-1 (control-saline), group-2
(lignocaine 0.5mg/kg) and group-3 (lignocaine 1mg/kg). They were administered study drug 2
minutes prior to extubation, following a standard peri operative anesthetic course. Hemodynamic
parameters like heart rate, systolic blood pressure, diastolic blood pressure and mean arterial
pressure (HR, SBP, DBP and MAP) prior to administration of the study drug and at 1min, 3min, 5min
and 10min post extubation were considered for statistical analysis. Post extubation cough graded as
per Eshak’s grading (Grade 0, 1, 2 and 3). Data obtained were analyzed using Analysis of variance
(ANOVA), Post-hoc Tukey test and Chi-square/Fisher Exact test. Results on continuous measurement
were, presented on Mean±SD. Significance was assessed at 5% level of significance. RESULTS: In
control group, there was significant rise in HR, SBP and MAP throughout the study period and the
incidence of moderate and severs cough was 43.3% and 30% respectively. Diastolic blood pressure
and mean arterial pressures attenuation with lignocaine 1mg/kg found to be superior (P<0.001).
There was no significant difference in heart rate and systolic blood pressure attenuation between
patients who received 0.5mg/kg lignocaine and 1mg/kg lignocaine at 1min (P - 0.101 and P - 0.938
respectively). Post extubation cough suppression was 100% in patients who received lignocaine
1mg/kg. CONCLUSION: Study concludes that lignocaine 1 mg/kg is superior to 0.5 mg/kg in
attenuating the hemodynamic responses to tracheal extubation. For post extubation cough
suppression (100%) lignocaine 1mg/kg is ideal.