Lidocaine, Dexmedetomidine, Esmolol and Magnesium Effect on Optic Nerve Sheath Diameter After Laryngoscopy

Launched by HASEKI TRAINING AND RESEARCH HOSPITAL · Feb 3, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how four different medications—lidocaine, dexmedetomidine, esmolol, and magnesium—affect the optic nerve sheath diameter during a procedure called laryngoscopy, which is often needed for general anesthesia and intubation. The optic nerve sheath diameter is important because changes in it can indicate pressure inside the skull, which is a concern for some patients. The trial involves patients aged 18 to 80 who need to be intubated for elective surgeries. Participants will be randomly assigned to receive one of the medications or none at all before the procedure, and researchers will measure the optic nerve diameter and monitor blood pressure and heart rate before and after laryngoscopy.

To be eligible for the study, patients should be in reasonably good health, classified as ASA Physical Status I to III, which means they are generally healthy or have mild systemic disease. However, individuals with certain health issues like severe heart problems, uncontrolled high blood pressure, or known neurological conditions won't be included. Participants can expect to undergo a standard procedure with additional monitoring, and the goal is to find the best approach to safely manage anesthesia for patients who may be sensitive to changes in brain pressure.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients aged 18 to 80 years who will receive endotracheal intubation for general anesthesia and have an American Society of Anesthesiologists (ASA) Physical Status classification of I to III.
• Exclusion Criteria:
• • Patients allergic to dexmedetomidine, esmolol, lidocaine, and magnesium; patients with uncontrolled hypertension or advanced heart failure with EF below 35%; patients with cardiac arrhythmia, especially Type 2 and 3 blocks, supraventricular arrhythmias. Patients with renal failure (GFR below 30) or severe liver failure; patients with known acute or previous intracranial pathology and known diagnosis of epilepsy, predefined difficult airway examination. Patients who required more than one attempt at intubation or total laryngoscopy took more than 20 seconds.