Fentanyl-clonidine & fentanyl-lidocaine on attenuation of hemodynamic stress response to laryngoscopy and tracheal intubation in cardiovascular surgery - A comparative study

Efficacy of Fentanyl-Clonidine & Fentanyl-Lidocaine in decreasing haemodynamic stress response during laryngoscopy and endotracheal intubation in cardiovascular surgeries  is being studied.

 Objectiveis to study the Efficacy of Fentanyl-Clonidine & Fentanyl-Lidocaine in decreasing haemodynamic stress response during laryngoscopy and endotracheal intubation in cardiovascular surgeries.

 Inclusion criteria:

·       Patients willing to sign informed consent

·       Male or Female patients between 18 to 60 years of age

·       Patients belonging to American Society of Anaesthesiologists(ASA) physical status I, II, & III

·       Patients posted for elective cardiovascular surgeries under general anaesthesia.

·       Patients with ejection fraction more than or equal to 40%

 Exclusion criteria:

·       Patients unwilling to participate in study.

·       Patients with Body Mass Index > 29 Kg/m^2

·       Patients with cerebrovascular diseases, hepatic and/or renal diseases

·       Psychiatric patients

·       Pregnancy and lactating women

·       Patients belonging to American Society of Anaesthesiologists (ASA) 4 and above.

·       Patients with ejection fraction less than 40%.

 We will be conducting this study on 72 adults aged 18-60 years belonging to grade I, II & III American Society of Anaesthesiologists classification who will undergo elective cardiovascular surgeries under general anaesthesia. They will be divided into 2 equal groups by chit method.

 Group FCwill receive Inj. Fentanyl 2 mcg/kg & Inj. Clonidine 2 mcg/kg 3 minutes prior to intubation.

Group FL will receive Inj. Fentanyl 2 mcg/kg & Inj. Lidocaine 1.5 mg/kg 3 minutes prior to intubation.

The intervention will be performed by Consultant Anaesthesiologist prior to intubation.

 Haemodynamic parameters are measured

1.     Before administration of test drugs (baseline)

2.     After administration of test drugs

3.      After induction

4.     At laryngoscopy & endotracheal intubation

5.     After intubation at 1st, 3rd, 5th & 7th minutes.

 Site of study:Dept of anaesthesiology, S.B.K.S. Medical Institute & Research centre, Sumandeep Vidyapeeth, Piparia, Waghodia, Vadodara, Gujarat

 **Study Design:**Prospective Randomised consoled study

 **Study Duration:**The study will be initiated after obtaining permission from institutional ethical committee till the achievement of the sample size or whichever is earlier.

 Numerical variables will be presented as mean & standard deviation (SD) while categorical variables will be presented as frequency and percentage. As regard to numerical variables; tests like unpaired student-t test and/or ANNOVA will be used wherever appropriate for between-groups comparisons, while for categorical variables; chi-square test will be used. P value <0.05 will be considered statistically significant. between-groups comparisons, while for categorical variables; chi-square test will be used. P value <0.05 will be considered statistically significant.

**Likely outcome:**This prospective and comparative study will help us to compare the efficacy between Fentanyl-Clonidine & Fentanyl-Lidocaine on haemodynamic stress response during laryngoscopy & endotracheal intubation in patients undergoing cardiovascular surgeries by having better outcome in haemodynamics.