Online ISSN: 2515-8260

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

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Dr. Harsha R, 2Dr. Mohan Kumar Ramiah Mahadeva,3Dr. Reshma Mulla,4Dr. Nataraj MS,5Dr. Manjunatha C,6Dr. CGS Prasad

Abstract

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.

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