Evaluation of Mexiletine Effect on Bispectral Index Changes and Hemodynamic Responses to Endotracheal Intubation and During General Anesthesia

  Background &Objective: Plaryngoscopy and tracheal intubation increase not only blood pressure and heart rate but also Bispectral Index (BIS) of the patients. In this study, hemodynamic and BIS changes were surveyed after tracheal intubation and during general anesthesia followed by mexiletine prescription . Materials & Methods: In this study, 50 patients aged between 20 and 60 who were candidates for orthopedic surgery of the upper limbs were surveyed. They were divided in two groups randomly. Two hours before induction of anesthesia,  case and control groups received mexiletine 200 mg as capsule and oral placebo, respectively. Systolic  and diastolic blood pressures ,heart rate, and BIS of both groups were compared before induction and intubation; 1,3 and 10 minutes after intubation; and immediately  , 15, 30, 45, and 60 minutes  after  surgical incision. Results:&nbsp;There was not any significant differences in systolic and diastolic pressures of the two groups.  The heart rate was lower in mexiletine group compared to control group, 30 minutes after surgical incision and immediately after extubation (P<0.05).&nbsp;BIS was significantly more in mexiletine groupcompared to control group (p<0/05). Conclusion: It was revealed that  the hemodynamic changes after laryngoscopy and during general anesthesia were significantly lower in mexiletine group compared to the  control group. It`s suggested that the prescription of this drug leads to the increase of BIS after intubation and during general anesthesia

Evaluation of intra ocular pressure and hemodynamic change following intubation with Maccoy, Macintosh and Video laryngoscope

Background & Objective: The induction of anesthesia, laryngoscopy and endotracheal intubation can be associated with adverse hemodynamic response and increased intraocular pressure. The aim of this study was to evaluate intraocular pressure and hemodynamic changes after laryngoscopy and endotracheal intubation with three methods of laryngoscopy (Macintosh, Maccoy and Video laryngoscope).Materials & Methods: One hundred and eighty patients with American Society of Anesthesiology (ASA) classification of I and II, aged 20-70 year, were enrolled in a randomized clinical trial (RCT). Anesthesia was induced by administration of Propofol 2 mg/kg, Fentanyl 1µg/kg and Cisatracurium 0.1mg/kg. the Hemodynamic information of the patients and intraocular pressures were documented and assessed in three stages (after induction of anesthesia and endotracheal intubation, and 5 minutes after endotracheal intubation using Maccoy, Macintosh and Video laryngoscope).Results: Hemodynamic parameters' of patients increased in these three groups compared with those of pre anesthesia measures, but this increase was not significant. Evaluation of intraocular pressure (IOP) in Video laryngoscope group showed that there is a significant drop in intraocular pressure (IOP) compared with other groups. There weren’t any significant differences of IOP after intubation in Maccoy compared to the Macintosh group. Nevertheless there was not any significant difference in IOP, before and five minutes after intubation in these groups.Conclusion: According to a low degree of augment of IOP in Video laryngoscope group and no changes in the Hemodynamic parameters, it seems that the use of Video laryngoscope in eye surgeries might be more suitable for endotracheal intubation