Comparison of the Efficacy of Lidocaine vs Propofol in Preventing Stress Response to Laryngoscopy in Pediatric Cardiac Surgery Patients
Abstract
The stress response due to laryngoscopy is an important issue in pediatric cardiac surgery patients that could be compromised in their cardiovascular functioning. Though lidocaine and propofol are both routinely employed in the reduction of this response, the relative effectiveness of these agents in this at-risk group is uncertain. This study aims to determine the relative efficacy of lidocaine compared to propofol in preventing the hemodynamic stress response to laryngoscopy in children undergoing cardiac surgery (aged 1-12 years), as evidenced by intraoperative monitoring. The study was a randomized controlled trial conducted at Khyber Teaching Hospital, Peshawar, involving 145 children who were scheduled to undergo elective cardiac surgery. The patients were assigned randomly to one of the following: intravenous lidocaine (1.5 mg/kg) or propofol (2.5 mg/kg) administration before laryngoscopy. The primary outcomes were monitored using heart rate, blood pressure, and plasma catecholamine levels. Standardized protocols were used to determine efficacy measures, including hemodynamic stability, catecholamine suppression, and overall stress response control. According to hemodynamic monitoring, lidocaine was successful in controlling the stress response in 78.9% of cases, and propofol was successful in controlling the stress response in 89.7% of cases. Generally, propofol has been proven to be more effective with fewer adverse outcomes. The research demonstrated that the prevention of stress response was effective in 122 cases, with 67 patients receiving lidocaine and 78 patients receiving propofol. Propofol demonstrated superior hemodynamic stability (OR: 2.34, p < 0.01) and catecholamine suppression compared to lidocaine. Propofol has a better effect than lidocaine in the prevention of the stress response caused by laryngoscopy in children undergoing cardiac surgery. Therefore, it is a better option for anesthesiologists handling such high-risk high-risk cases.
Keywords: Laryngoscopy Stress Response, Pediatric Cardiac Surgery, Lidocaine, Propofol, Hemodynamic Stability, Anesthetic Premedication, Cardiovascular Protection
