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Recruiting NCT07192081

Comparative Efficacy of Intravenous Labetalol and Lignocaine in Mitigating Hemodynamic Responses to Laryngoscopy During Laparoscopic Cholecystectomy

No phase Interventional Intubation Anesthesia Laparoscopic Cholecystectomy Hemodynamic Response to Laryngoscopy

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Labetalol, Lignocaine.
Who it may be relevant to
Registry conditions: Intubation, Anesthesia, Laparoscopic Cholecystectomy, Hemodynamic Response to Laryngoscopy. Basic parameters: 18 years — 60 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Pakistan
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

Comparative Efficacy of Intravenous Labetalol and Lignocaine in Mitigating Hemodynamic Responses to Laryngoscopy During Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Overview

Laryngoscopy and intubation during laparoscopic cholecystectomy often cause sudden increases in heart rate and blood pressure, which can be harmful in some patients. Medications such as labetalol and lignocaine are commonly used to reduce this hemodynamic response. This randomized controlled trial at Hayatabad Medical Complex, Peshawar, will compare intravenous labetalol (0.25 mg/kg) and lignocaine (1.5 mg/kg), administered 3 minutes before laryngoscopy. A total of 116 patients undergoing elective laparoscopic cholecystectomy will be randomly assigned to either drug group. The primary goal is to determine which drug is more effective in keeping heart rate and mean arterial pressure within ±20% of baseline during and after intubation. The study will also record blood pressure trends, intubation details, rescue medications, and adverse events such as bradycardia or hypotension. Results will help guide anesthesiologists in selecting the safer and more effective option to maintain cardiovascular stability during surgery.

Detailed description

Laparoscopic cholecystectomy is the standard surgical treatment for symptomatic gallstones. However, laryngoscopy and endotracheal intubation during anesthesia often trigger a sympathetic surge, resulting in tachycardia and hypertension. These hemodynamic changes, although short-lived, may increase perioperative risk, especially in patients with limited cardiovascular reserve.

Labetalol, a combined α1- and β-adrenergic antagonist, reduces both heart rate and arterial pressure by blunting sympathetic activity. Lignocaine, an amide local anesthetic, also exhibits sympatholytic effects when given intravenously. Both agents are widely used in anesthesia practice, but direct head-to-head evidence in the setting of laparoscopic cholecystectomy remains limited.

This randomized controlled study will evaluate and compare the efficacy of intravenous labetalol and lignocaine in attenuating pressor and tachycardic responses to laryngoscopy. The trial will include adult ASA I patients scheduled for elective laparoscopic cholecystectomy. Participants will be randomly assigned to receive either labetalol 0.25 mg/kg or lignocaine 1.5 mg/kg intravenously, 3 minutes before laryngoscopy. Hemodynamic variables (heart rate, systolic, diastolic, and mean arterial pressures) will be tracked peri-intubation. The occurrence of adverse events such as bradycardia, hypotension, or allergic reactions will also be monitored.

By directly comparing these two commonly used drugs in a controlled setting, the study aims to clarify which provides superior cardiovascular stability during airway instrumentation. Findings will contribute to evidence-based guidance for anesthesiologists in selecting pharmacologic strategies that minimize perioperative risk in laparoscopic surgery.

Interventions

  • Drug Labetalol
    Labetalol 0.25 mg/kg intravenous bolus over 60 seconds, administered 3 minutes before laryngoscopy.
  • Drug Lignocaine
    Lignocaine 1.5 mg/kg intravenous bolus over 60 seconds, administered 3 minutes before laryngoscopy.

Primary outcome measures

  • Change in Systolic Blood Pressure (SBP) Following Laryngoscopy [Time frame: From 5 minutes before induction to 10 minutes after intubation.]
Secondary outcome measures (4)
  • Change in Diastolic Blood Pressure (DBP) [Time frame: From 5 minutes before induction to 10 minutes after intubation.]
  • Change in Mean Arterial Pressure (MAP) [Time frame: From 5 minutes before induction to 10 minutes after intubation..]
  • Change in Heart Rate [Time frame: From 5 minutes before induction to 10 minutes after intubation.]
  • Incidence of Adverse Events [Time frame: From induction through recovery (approx. 1 hour)]

Eligibility criteria

Inclusion criteria

  • ASA Grade I and II
  • Age 18 to 60 years
  • Elective laparoscopic cholecystectomy
  • Both genders
  • Informed consent given

Exclusion criteria

  • Hypersensitivity to labetalol/lignocaine
  • Hypertensive on antihypertensives
  • ASA Grade III or more
  • Cardiovascular, renal, hepatic, or endocrine issues
  • Pregnant/lactating
  • BMI ≥ 35
  • Anticipated difficult airway

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Double blind
Primary purpose
Treatment

Study locations

Pakistan · 1 center
  • Hayatabad Med Complex — Peshawar

Identifiers

NCT: NCT07192081 · CPSP/REU/ANS-2023-021-3099

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗