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A Comparative Study of Lignocaine Nebulization with Intravenous Lignocaine in Attenuation of Pressor
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Why is it important?
Background: Laryngoscopy and endotracheal intubation is often associated with hypertension and tachycardia because of sympatho-adrenal stimulation which is usually transient. In patients with cardiovascular and cerebrovascular diseases, the sudden hemodynamic response can produce deleterious effects in the form of myocardial ischaemia or infarction, arrhythmias, cardiac failure, raised ICP and cerebral haemorrhage. In view of this, the present study was undertaken to evaluate and compare the effects of 2% Lignocaine 2 mg/kg nebulization given 10 minutes and 2% Lignocaine 2 mg/kg iv given 90 seconds before induction for attenuation of intubation response. Materials & methods: Sixty ASA Grade I & II patients in the age group 20-60 years of either sex scheduled for elective surgeries under general anaesthesia were allocated into Group A and Group B with the sample size of 30 in each. Group A received nebulization with 2% lignocaine 2 mg/kg 10 minutes and Group B received 2% lignocaine 2 mg/kg intravenous 90 sec before induction. Heart rate, systolic and diastolic blood pressure and mean arterial pressure and SpO2 were recorded, basal values and subsequently at 1st, 3rd, 5th, 7th and 10th minute after intubation. Results: It was noted that, Group A, the rise of HR, SBP, DBP, MAP at 1 min after intubation were found to be 24.86 bpm, 9.6 mm Hg, 20.44 mm Hg, 22.30 mm Hg respectively. In Group B, the rise of HR, SBP, DBP, MAP were found to be 11.7 bpm, 3 mm Hg, 2.61 mm Hg, 4.77 mm Hg respectively. Conclusion: It was seen that use of lignocaine has suppressed heart rate and blood pressure changes to laryngoscopy and endotracheal intubation. In fact intravenous lignocaine has better suppressing property than nebulization of lignocaine.
Perspectives
Background: Laryngoscopy and endotracheal intubation is often associated with hypertension and tachycardia because of sympatho-adrenal stimulation which is usually transient. In patients with cardiovascular and cerebrovascular diseases, the sudden hemodynamic response can produce deleterious effects in the form of myocardial ischaemia or infarction, arrhythmias, cardiac failure, raised ICP and cerebral haemorrhage. In view of this, the present study was undertaken to evaluate and compare the effects of 2% Lignocaine 2 mg/kg nebulization given 10 minutes and 2% Lignocaine 2 mg/kg iv given 90 seconds before induction for attenuation of intubation response. Materials & methods: Sixty ASA Grade I & II patients in the age group 20-60 years of either sex scheduled for elective surgeries under general anaesthesia were allocated into Group A and Group B with the sample size of 30 in each. Group A received nebulization with 2% lignocaine 2 mg/kg 10 minutes and Group B received 2% lignocaine 2 mg/kg intravenous 90 sec before induction. Heart rate, systolic and diastolic blood pressure and mean arterial pressure and SpO2 were recorded, basal values and subsequently at 1st, 3rd, 5th, 7th and 10th minute after intubation. Results: It was noted that, Group A, the rise of HR, SBP, DBP, MAP at 1 min after intubation were found to be 24.86 bpm, 9.6 mm Hg, 20.44 mm Hg, 22.30 mm Hg respectively. In Group B, the rise of HR, SBP, DBP, MAP were found to be 11.7 bpm, 3 mm Hg, 2.61 mm Hg, 4.77 mm Hg respectively. Conclusion: It was seen that use of lignocaine has suppressed heart rate and blood pressure changes to laryngoscopy and endotracheal intubation. In fact intravenous lignocaine has better suppressing property than nebulization of lignocaine.
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This page is a summary of: A Comparative Study of Lignocaine Nebulization with Intravenous Lignocaine in Attenuation of Pressor Response to Laryngoscopy and Intubation, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.48.
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