Online ISSN: 2515-8260

Keywords : Attenuation

Comparison of sublingual nitroglycerine spray with oropharyngeal lignocaine spray for blunting response to laryngoscopy and intubation

Dr. Harsha R, Dr. Mohan Kumar Ramiah Mahadeva,Dr. Reshma Mulla,Dr. Nataraj MS,Dr. Manjunatha C,Dr. CGS Prasad

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1218-1226

Background: Endotracheal intubation is a common mode of securing the airway for
administering general anaesthesia. Direct laryngoscopy and endotracheal intubation is almost
always associated with haemodynamic changes due to reflex sympathetic stimulation caused
by laryngopharyngeal stimulation.
Methods: A prospective, randomized controlled clinical study was undertaken to compare
the efficacy of oropharyngeal lignocaine spray (group L,n=30) and sublingual nitroglycerine
spray (group N, n=30) in blunting of haemodynamic response to laryngoscopy and intubation
belonging to ASA I, posted for surgery under general anaesthesia.
Results: There was statistically significant difference in the mean heart rate between the
groups for the first 3 minutes after intubation. Statistical evaluation between the groups
showed the mean SBP was statistically significant (p=0.036) for initial 3 mins after intubation
and also at 5th 6th & 10th minute. Statistical evaluation between the groups showed that
mean DBP 1st minute after intubation was statistically significant (p=0.008). The difference
was significant at 4, 5, 6 and 9 min after intubation. Statistical evaluation between the groups
did not show any statistical difference in the MAP except at 5th & 6th minute. However,
there was no clinically significant difference in any of the above groups.
Conclusion: Both sublingual NTG & lignocaine group successfully blunted the intubation
response, sublingual NTG spray was better in suppressing the BP response to laryngoscopy
and intubation than oropharyngeal lignocaine spray but lignocaine controlled the HR
response better than NTG.


Dhanshree Kale; Arachna Amol Gautam; Shraddha Naik; Avinash G. Bhosale; P. B. Patil; R. N. Mulla

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4112-4117

A prospective, randomized study was performed after acceptance by the Ethics Committee and informed consent of 60 patients seeking elective surgery at the Krishna Hospital and the Medical Research Centre, Karad. The study objective is to evaluate haemodynamic consistency through attenuation of the pressure reaction during laryngoscopy and endotracheal intubation. Group A obtained pregabalin orally with water sips before induction and Group B served as control group, received multivitamin orally with sips of water 1hr before induction. Both groups were uniform in their distribution of age, weight and gender. They had similar physical status with no coexisting disease. Both groups were managed with same anesthetic protocol. It was concluded that the preoperative sedation before giving premedication in control and pregabalin groups are comparable, whereas pregabalin produced better preoperative sedation after one hour of premedication, as evidenced by higher Ramsay sedation score.