Evaluation of nebulized lignocaine versus intravenous lignocaine for attenuation of pressor response to laryngoscopy and intubation

Ganesan, Priya; Balachander, Hemavathy; Elakkumanan, Lenin Babu

doi:10.4103/cmi.cmi_50_20

Cited by 6 publications

(3 citation statements)

References 1 publication

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“…lignocaine. 24 In our study, hypotension was seen in four cases in group A and no hypotension in group B. Charan et al observed that in clonidine group (1 µg/kg), 15 out of 50 patients had hypotension, which was treated by rapid i.v. fluids, and 3 out of 50 patients developed bradycardia.…”

Section: Demographic Profilesupporting

confidence: 47%

Intravenous Clonidine with Lignocaine Nebulization to Attenuate the Hemodynamic Response to Laryngoscopy and Tracheal Intubation: A Comparative Study

Kaur¹,

Kumari²,

Chawla³

2021

AMEI's Current Trends in Diagnosis &Amp; Treatment

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Introduction:The present study was conducted to compare the efficacy of intravenous (i.v.) clonidine with that of lignocaine nebulization for attenuation of pressor response to laryngoscopy and tracheal intubation. Materials and methods: Fifty patients of either sex aged between 18 years and 60 years covered under American Society of Anesthesiologists health status classes I and II, undergoing elective surgery under general anesthesia requiring endotracheal intubation, were considered. Patients were randomly divided into two groups. Group A received i.v. clonidine 1 μg per kg and nebulization with 3 mg per kg of 4% lignocaine, and group B received i.v. normal saline and nebulization with 3 mg per kg of 4% lignocaine before intubation. Hemodynamic parameters were noted at baseline, after giving study drug, every minute after intubation for 10 minutes and then every 10 minutes thereafter till the end of the surgery. Results: It was noted that in group A, the rise of HR, SBP, DBP, and MAP 1 minute after intubation was found to be 85.4 bpm, 117.5, 70.6, and 86.2 mm Hg, and in group B, the rise of HR, SBP, DBP, and MAP 1 minute after intubation was found to be 93.9 bpm, 129.9, 85.2, and 100.1 mm Hg, respectively. Nebulized lignocaine was not found effective in attenuating hemodynamic response to intubation, and hemodynamic parameters were significantly high after intubation as compared to clonidine group. Conclusion:In our study, i.v. clonidine in a dose of 1 µg per kg administered 15 minutes before laryngoscopy, and intubation was far superior to nebulized lignocaine alone in attenuation of the hemodynamic response.

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Section: Demographic Profilesupporting

confidence: 47%

Intravenous Clonidine with Lignocaine Nebulization to Attenuate the Hemodynamic Response to Laryngoscopy and Tracheal Intubation: A Comparative Study

Kaur¹,

Kumari²,

Chawla³

2021

AMEI's Current Trends in Diagnosis &Amp; Treatment

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“…Later on, various studies had investigated the effects of nebulised lignocaine versus, the commonly used, intravenous lignocaine on pressor response. Ganesan et al ,[ 8 ] in their study on 100 adult patients, reported that nebulised lignocaine (8 ml of 2%) for 20 min may be more effective than intravenous lignocaine (1.5 mg/kg) in suppressing the pressor response. This result was consistent with another study that included 40 adult patients and used 5 ml of lignocaine 2% in both routes of administration.…”

Section: Discussionmentioning

confidence: 99%

Preoperative lignocaine nebulisation for attenuation of the pressor response of laryngoscopy and tracheal intubation in patients with severe preeclampsia undergoing caesarean section delivery: A randomised double-blind controlled trial

Nabil,

Gharib,

Gadelrab

et al. 2023

Indian Journal of Anaesthesia

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Background and Aims: Following induction of general anaesthesia, direct laryngoscopy and endotracheal intubation usually cause tachycardia and hypertension due to increased sympathetic activity. This response is generally exaggerated in hypertensive patients. This study aimed to evaluate the effectiveness of preoperative lignocaine nebulisation in attenuating the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery. Methods: After ethical approval, we conducted this randomised, double-blind study, which included 110 patients with severe preeclampsia who underwent caesarean delivery under general anaesthesia. These patients were randomly allocated into two groups to receive either preoperative nebulisation of lignocaine 2% in a dose of 4.5 mg/kg (not exceeding 400 mg) in the lignocaine group or nebulisation of an equivalent volume of 0.9% NaCl in the saline group. The primary objective was the systolic blood pressure after tracheal intubation. The secondary objectives included heart rate, maternal serum cortisol and blood glucose levels, grade of cough during emergence, postoperative sore throat and hoarseness of voice, neonatal Apgar score and umbilical blood gas. Results: The systolic blood pressure was significantly lower in the lignocaine group compared to the saline group at 1, 3 and 5 min after endotracheal intubation and after delivery of the foetus ( P = 0.001, 0.003, 0.002 and 0.019, respectively). Similarly, the heart rate was significantly lower in the lignocaine group versus saline group at 1 and 3 min after endotracheal intubation ( P = 0.041 and 0.042, respectively). Conclusion: Preoperative lignocaine nebulisation in a dose of 4.5 mg/kg effectively attenuated the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery.

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“…Gupta A et al and Gansesan P et al have compared nebulised lidocaine with intravenous lidocaine and they observed that nebulised lidocaine was able to attenuate haemodynamic responses better than intravenous lidocaine. 25,26 The primary objective of our study was to compare MAP between the two groups & the other objectives of our study were to compare SBP, DBP and HR between the two groups. In our study, we have observed that rise in MAP, SBP, DBP & HR immediately after intubation was lesser in the lidocaine group in comparison to the control group.…”

Section: Discussionmentioning

confidence: 99%

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

Gaurav¹,

Verma²,

Verma³

et al. 2022

IJCA

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: 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.

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Evaluation of nebulized lignocaine versus intravenous lignocaine for attenuation of pressor response to laryngoscopy and intubation

Cited by 6 publications

References 1 publication

Intravenous Clonidine with Lignocaine Nebulization to Attenuate the Hemodynamic Response to Laryngoscopy and Tracheal Intubation: A Comparative Study

Intravenous Clonidine with Lignocaine Nebulization to Attenuate the Hemodynamic Response to Laryngoscopy and Tracheal Intubation: A Comparative Study

Preoperative lignocaine nebulisation for attenuation of the pressor response of laryngoscopy and tracheal intubation in patients with severe preeclampsia undergoing caesarean section delivery: A randomised double-blind controlled trial

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

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