Journal of Anesthesiology and Pain

Background and aims
We have compared the effects of lidocaine, remifentanil and placebo on the hoemodynamic
responses to tracheal extubation.
Methods
This was a prospective, randomized clinical trial, double-blind study in 18 to 50 years old adults
with ASA I - II, undergoing an orthopedic surgery. Anesthesia was induced with fentanyl 2 μg/kg
IV and propofol 1.5 mg/kg and atracurium 0.6 mg/kg, and maintained with propofol 100
μg/kg/min and repeated doses of atracurium 0.2 mg/kg. Ten and 50 minutes before the end of
surgery, propofol and fentanyl were discontinued respectively. At the end of surgery a bolus
dose of Remifentanil 0.25 μg/kg or Lidocaine 1.5 mg/kg or 5 ml normal saline was given and
tracheal extubation was performed after standard criteria acheivement. Arterial pressure and
heart rate were recorded at the time of 1,5,10 intervals from the end of surgery.
Results
There were statistically significant differences between the lidocaine and remifentanil group
with respect to hemodynamic parameters (heart rate, diastolic blood pressure) at 5, 10 min
intervals from the end of surgery. Systolic blood pressure at three times was significantly
different in three groups.
Conclusions
Remifentanil is more effective than lidocaine on cardiovascular response control during
emergence from anesthesia and extubation.