Comparison of the efficacy of intravenous Lidocaine and Remifentanil on hemodynamic responses at the time of extubation

We have compared the effects of lidocaine، remifentanil and placebo on the hoemodynamic responses to tracheal extubation. 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/kgIV and propofol 1. 5 mg/kg and atracurium 0. 6 mg/kg، and maintained with propofol 100μg/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. 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. Remifentanil is more effective than lidocaine on cardiovascular response control during emergence from anesthesia and extubation.