title: The effect of intravenous magnesium sulfate and lidocaine in hemodynamic responses to endotracheal intubation in elective coronary artery bypass grafting: a randomized controlled clinical trial.
abstract: BACKGROUND
  There have been many concerns about alteration in hemodynamic parameters within and shortly after endotracheal intubation (ETI) in patients scheduled for elective coronary artery bypass grafting (CABG).
  
  
  OBJECTIVE
  We compared the attenuation effect of magnesium sulfate and lidocaine on hemodynamic responses after ETI, in patients undergoing CABG.
  
  
  METHODS
  In this randomized controlled trial 150 patients undergoing elective CABG were enrolled. Included patients were randomly allocated to three groups and received lidocaine (1.5 mg/kg), magnesium sulfate (50 mg/kg within five minute), or normal saline, 90 seconds before ETI. Baseline hemodynamic parameters including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded immediately before anesthesia induction, before intubation, immediately after intubation, and at second and fifth minutes after intubation.
  
  
  RESULTS
  The baseline hemodynamic variables had no deference among the three groups. HR between intubation and five minute after intubation was significantly lower in two groups received lidocaine or magnesium sulfate in comparison with placebo group. Lidocaine induced more than 20% decrease in HR and MAP immediately after intubation; hence, lidocaine group showed significant MAP reduction in comparison with the two other groups.
  
  
  CONCLUSIONS
  Lidocaine induced hemodynamic instability but premedication of magnesium sulfate maintained hemodynamic stability after intubation. Therefore, in patients undergoing CABG who received high-dose intravenous analgesic for general anesthesia, the administration of magnesium sulfate might result in maintaining hemodynamic stability after ETI in comparison with lidocaine.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Mesbah Kiaee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Safari
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Movaseghi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Mohaghegh Dolatabadi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Ghorbanlo
authors.affiliation: Students' Scientific Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrnoosh
authors.initials: M
authors.lastname: Etemadi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Arash
authors.initials: SA
authors.lastname: Amiri
authors.affiliation: Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran ; Students' Scientific Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Zamani
keywords: Coronary Artery Bypass Grafting; Endotracheal Intubation; Hemodynamic; Lidocaine; Magnesium Sulfate