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Lidocaine-based anesthesia had been recently reported as a successful regimen for induction of anesthesia in elderly population with better hemodynamic profile than opioid-based induction. The investigators hypothesize that lidocaine-based induction of anesthesia would provide superior hemodynamic profile compared to conventional opioid-based induction of anesthesia in emergency laparotomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lidocaine group | Active Comparator | Patients will receive 1 mg/kg lidocaine intravenously (IV) |
|
| Fentanyl group | Active Comparator | Patients will receive 1 mcg/kg fentanyl intravenously (IV) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lidocaine | Drug | After preoxygenation with 100% oxygen for 3 minutes, the study drug (lidocaine) will be administered. Patients will receive 1 mg/kg lidocaine of 10 mg/mL lidocaine solution (prepared by diluting 5 mL of lidocaine 20% in saline to a total volume of 10 mL) |
| Measure | Description | Time Frame |
|---|---|---|
| Hypotension | Incidence of post-induction hypotension | immediately after induction of anesthesia until 20 minutes after induction of anesthesia |
| Measure | Description | Time Frame |
|---|---|---|
| Norepinephrine dose | Total norepinephrine dose during the period from induction of anesthesia until 20-minutes after intubation or skin incision | from induction of anesthesia until 20 minutes after skin incision |
| Heart rate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jehan Elkholy, M.D. | Cairo University | Study Chair |
| Eman F Ali,, M.D. | Cairo University | Study Director |
| Kareem MA Nawwar, M.D. | Cairo University | Study Director |
| Mohsen M Waheeb, M.D. | Cairo University | Study Director |
| Samar M Abdel Azeim Ghazala, M.Sc. | Cairo University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine, Cairo University | Cairo | Egypt |
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| ID | Term |
|---|---|
| D008012 | Lidocaine |
| D005283 | Fentanyl |
| D015742 | Propofol |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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| Fentanyl | Drug | After preoxygenation with 100% oxygen for 3 minutes, the study drug (fentanyl) will be administered. Patients will receive 1 mcg/kg fentanyl of 10 mcg/mL fentanyl solution (prepared by diluting 100 mcg fentanyl in saline to a total volume of 10 mL). |
|
| Propofol | Drug | After administration of the study drug, all patients will receive 2 mg/kg propofol intravenously |
|
| Succinyl choline | Drug | After loss of consciousness, 1 mg/kg succinyl choline will be administered over 5 seconds, and tracheal intubation will be done through direct laryngoscopy after 60 seconds. |
|
| every 2 minutes for 20 minutes after induction of anesthesia |
| Mean Arterial Pressure | every 2 minutes for 20 minutes after induction of anesthesia |
| Aniline Compounds |
| D000588 | Amines |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |