A prospective study evaluating the effect of nebulised lidocaine on haemodynamic responses during nasotracheal intubation

Abstract

: Laryngoscopy and endotracheal intubation result in a significant increase in haemodynamic stress response which is well tolerated by healthy patients but in patients with significant coronary artery or cerebrovascular diseases, if it is not prevented adequately may lead to myocardial ischemia and cerebral haemorrhage.: This prospective comparative study was conducted between August 2019-July 2020 to study the effect of nebulised lidocaine on haemodynamic stress responses (primarily mean arterial blood pressure also heart rate, systolic blood pressure and diastolic blood pressure) during nasotracheal intubation. 94 patients who underwent head and neck surgery under general anaesthesia requiring nasotracheal intubation were randomised into two groups using a computational random number, Group A (control group): was nebulised with 5 ml of normal saline. Group B: was nebulised with 5ml of Lidocaine 4% solution. Heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial blood pressure(MAP), and SpO2 were observed before and after nebulisation, just before intubation, immediately after intubation and at 3, 5 10 min after intubation.: On comparing SBP, DBP, MAP and heart rate immediately after intubation with pre-intubation values, there was a significant surge in both groups but an increase in the control group was more in comparison to the lidocaine group(p<.05). Thereafter MAP, SBP, DBP and HR gradually decreased till the duration of study i.e. 10 minutes.: The administration of nebulised 4% Lidocaine inhalation before induction attenuates cardiovascular response (primarily in terms of MAP also SBP, DBP and HR) that occurs due to nasotracheal intubation.