European Journal of Molecular & Clinical Medicine

Purpose: The purpose of this study was to determine the hemodynamic effect of intravenous lornoxicam during laryngoscopy and endotracheal intubation and to determine whether intravenous lornoxicam is effective in reducing the hemodynamic stress response to laryngoscopy and endotracheal intubation.
Methods: It was a double blind randomized control trial to investigate the effect of lornoxicam on the change in blood pressure, heart rate observed during laryngoscopy and tracheal intubation in 50 ASA class I and II patients. 50 patients with similar characteristics were divided into groups of 25 each. One group received lornoxicam, while the other received a placebo.
Results: Blood pressure and heart rate was recorded at various intervals during laryngoscopy and endotracheal intubation.  It was observed that there was a significant attenuation in heart rate and blood pressure response to laryngoscopy and intubation for the lornoxicam group.
Conclusion: The use of IV lornoxicam during laryngoscopy and intubation can save lives since it significantly lowers the hemodynamic reactions to intubation when administered 30 minutes prior to the surgery.

The sympathetic system · in response to stress acts to increase heart rate, blood pressure, cardiac output, dilates bronchial tree and shunts blood away from skin and viscera to muscles. A powerful noxious stimulus like laryngoscopy and tracheal intubation induces hypothalamic activity and results in an increased outflow in the sympathetic tracts. Consequently, norepinephrine is released by post ganglionic sympathetic fibers and increased secretion from adrenal medulla. A preanesthetic evaluation of history of surgical and medical illness, drug allergies previous anaesthetic exposure and Baseline investigations of blood, ECG, radiograph of chest and airway examination was done. Patient was kept nil by mouth for at least 8hrs prior to surgery. All patients were premedicated with injection Pantoprazole 40mg (IV) one hour prior to surgery. Preoperative vital parameters like baseline pulse, blood pressure were noted. Mean arterial pressure (MAP) significantly lower in Group D patient at 4 minutes, 6 minutes, 8 minutes, I0 minutes, 15 minutes, 20 minutes after intubation compared to Group C. Heart rate was on lower side in group D compared to Group C but the difference was significant statistically after 6 minutes of intubation till 25 minutes post intubation.