A comparative study between nitroglycerine spray and lignocaine spray to attenuate hemodynamic changes during laryngoscopy and intubation

Abstract

Endotracheal intubation which is a frequent maneuver in general anaesthesia is accompanied by adverse hemodynamic changes like hypertension, tachycardia and cardiac dysrhythmias. This study aims at comparing the efficacy of nitroglycerine spray and lignocaine spray to attenuate the hemodynamic changes during direct larngoscopy and intubation. This prospective study included 60 patients of age group 20 to 45 years of either sex belonging to American Society of Anaesthesiologist (ASA) grade 1 & 2 posted for elective surgery under general anaesthesia. These patients were randomly allocated in 3 groups of 20 each. Prior to induction, patients in Group N received one puff of nitroglycerine (0.4 mg) spray sublingually, Group L received five puffs of lignocaine spray (10 mg each) in oropharynx and group C received none of the two drugs serving as control group. Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and oxygen saturation were recorded at fixed time intervals. Both nitroglycerine spray and lignocaine spray attenuate the hemodynamic changes during laryngoscopy and intubation. Nitroglycerine spray is more effective in attenuating the blood pressure changes accompanied by a significant rise in heart rate due to its vasodilatory action whereas lignocaine spray is more effective in attenuating the changes in heart rate. No complications or side effects were observed in any of the group.