Ep 42: Medications that Blunt the Sympathetic Response to Laryngoscopy & Intubation

Episode SummaryIn this episode of The Nurse Anesthesia Podcast Jeremy discusses the medications used to block/inhibit/blunt the sympathetic response to laryngoscopy and intubation. He discusses the mechanisms of how lidocaine, fentanyl, esmolol, or dexmedetomidine can be used to limit or even prevent the tachycardia and hypertension that can occur from placing a laryngoscope blade into the hypopharynx. Gear up…because we’re about to explain how to do laryngoscopy without the hyperdynamic drama! References1.    Chung KS, et al. “A comparison of fentanyl, esmolol, and their combination for blunting the haemodynamic responses during rapid-sequence induction.” doi:10.1007/BF030082872.    Gurulingappa, et al. “Attenuation of Cardiovascular Responses to Direct Laryngoscopy and Intubation-A Comparative Study Between iv Bolus Fentanyl, Lignocaine and Placebo(NS).” doi:10.7860/JCDR/2012/4070.2619 3.    Hassani V, et al. “Comparison of fentanyl and fentanyl plus lidocaine on attenuation of hemodynamic responses to tracheal intubation in controlled hypertensive patients undergoing general anesthesia. doi:10.5812/aapm.64424.    Mendonça FT, et al. “Effects of lidocaine and esmolol on hemodynamic response to tracheal intubation: a randomized clinical trial.” doi:10.1016/j.bjane.2021.01.0145.    Mulimani SM, et al. “Efficacy of a Bolus Dose of Esmolol and Bolus Dose of Lignocaine for Attenuating the Pressor Response to Laryngoscopy and Endotracheal Intubation in General Anesthesia: A Comparative Study.” . doi:10.4103/aer.AER_31_196.    Qi DY, et al. “Efficacy of intravenous lidocaine versus placebo on attenuating cardiovascular response to laryngoscopy and tracheal intubation: a systematic review of randomized controlled trials.” 7.    Qin J, et al. “Effects of intravenous lignocaine on haemodynamic responses to laryngoscopy and tracheal intubation in adults under general anaesthesia: A systematic review and meta-analysis.” doi:10.4103/ija.ija_201_25 8.    Saleh A, et al. “Effects of Dexmedetomidine vs Esmolol on Postintubation Hemodynamics: A Meta-Analysis.” doi:10.2344/23-00599.    Sharma S, et al. “Comparison of Esmolol and Dexmedetomidine for Suppression of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation in Adult Patients Undergoing Elective General Surgery: A Prospective, Randomized Controlled Double-blinded Study.” . doi:10.4103/aer.AER_226_1710. Teong, Cheng Yeon et al. “The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial.” doi:10.1038/s41598-020-65711-9 Resources/information discussed in podcast  About The Nurse AnesthesiaFor anyone who wants to learn or if you just want to review anesthesia concepts…we will set you up for a successful educational jOURney by providing short, meaningful courses to accelerate your nurse anesthesia learning, tackle your training, and become the successful CRNA you want to be. Let's do this together. It's Go Time!Visit us at www.thenurseanesthesia.com   Sign up for The Nurse Anesthesia CoursesOur CRISIS MANAGEMENT SERIES is currently available! CRNAs & RN’s get CE credits when they purchase & complete this series.Resident Registered Nurse Anesthesiologists get a steep discount! Email us at [email protected] to get your discount code.Learn more about our courses at www.thenurseanesthesia.com   Follow us on Instagram