Abstract

Laryngoscopy and tracheal intubation is associated with a reflex sympathetic pressor response which results in increased heart rate and blood pressures. This may prove detrimental in high-risk patients. Objective of this study is to compare the effects of intravenous lignocaine and oral nitroglycerin spray in attenuation of this response. Methods: 90 ASA I and II status normotensive patients scheduled for elective surgical procedures were selected randomly and divided into three groups of 30 each. All patients received premedication, the first group was control group, in this group no drug was administered for attenuating sympathetic response to laryngoscopy and intubation, the second group received 2mg/kg lignocaine i.v. bolus and the third group received 0.4mg/1 spray of sublingual nitroglycerin, 3 minutes before laryngoscopy and intubation. HR, systolic, diastolic blood pressure were recorded noninvasively before induction, postinduction, 1,3,5, 7 and 10 minutes from the onset of laryngoscopy.‘ ANOVA’ test was used for statistical analysis. Results: Post intubation incidence of tachycardia (HR>100/min) was significantly higher in control and nitroglycerin group (p<0.05) than in lignocaine group. Rise in SBP and DBP were also statistically significant in control and nitroglycerin group than in lignocaine group (p<0.05) Interpretation and Conclusion: Attenuation of pressor response is seen both with lignocaine and nitroglycerin. Of the two drugs lignocaine 2mg/kg i.v. bolus provides a consistent, reliable and effective attenuation as compared to sublingual nitroglycerin spray 0.4mg.

Description