Effects of Lidocaine versus Remifentanil during tracheal extubation when emergence from general anaesthesia

Abstract

Back ground &Objective: Extubation under deep anaesthesia decreases cardiovascular stimulation and reduces the incidence of coughing and straining on the tube. we investigate the effects of intravenous  lidocaien and remifentanil on patients responses to the tracheal tube during recovery from general anaesthesia after laparoscopic cholecystectomy, and safety of remifentanil during spontaneous ventilation.

Materials and Methods: In randomized clinical trial, (50) patient(12M/38F),(39.98±15.6)old age, ASA class Ⅰ-Ⅱ, scheduled for elective laparoscopic cholecystectomy were allocated to receive remifentanil: R group n=25 (TCI=2ng ml^-1), L group n=25(1.5 mg kg^-1) during recovery from anaesthesia. Heart rate, blood pressure,EtCo2,respiratory rate,Spo2 were measured in 4 min, the first 2min before extubation, time of extubation,1min after extubation.Time to eye opening, orientation time, and Aldrete scores  were recorded. we used T-test for statistical analysis when P<0.05.

Results: There were no significant differences in heart rate and blood pressure, except in the 4min, R group had better control(P<0.05). EtCo2, respiratory rate, Spo2 confirmed the efficacy of spontaneous ventilation. Cough noticed in 4%(R group),and 2%(L group). Recovery scores were better in R group(P=0.000).

Conclusion: TCI of remifentanil protects spontaneous ventilation, and reduces responsiveness to the tracheal tube during emergence from general anaesthesia a little more effectively than does i.v. lidocaine in patients undergoing laparoscopic cholecystectomy.