Comparison of Nitroglycerin versus Lignocaine Spray to Attenuate Haemodynamic Changes in Elective Surgical Patients Undergoing Direct Laryngoscopy and Endotracheal Intubation: A prospective randomised study

Varshney, Rohit Kumar; Prasad, Mukesh Kumar; Garg, Megha

doi:10.18295/squmj.2019.19.04.007

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…However, the fear of the side effects of narcotic drugs always limits the variety of their use. Varshney et al demonstrated the TNG alone was more effective than anesthetic drug in reducing hemodynamic pressor response during intubation (15), which is consistent with the results of our study. Also, the results of the study by Firoozbakhsh et al have found TNG injection to be effective in preventing unwanted complications of intubation (16).…”

Section: Discussionsupporting

confidence: 93%

Investigating the Effects of Fentanyl and Nitroglycerin on Hemodynamic Changes During Laryngoscopy: A Randomized Trial

Aminisaman,

Nazari,

Aminisaman

et al. 2023

J Clin Res Paramed Sci

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Background: Laryngoscopy is the required procedures in general anesthesia that can cause cardiovascular disorders for the patient. Various pharmacological methods are used to reduce unwanted laryngoscopy responses. Objectives: The present study aimed to compare the effects of fentanyl and nitroglycerin spray on hemodynamic responses during laryngoscopy. Methods: In a clinical trial study, 40 patients were divided into two groups. In one group of patients, intravenous fentanyl (2 µg/kg) was given and in the other group, 2 puffs sublingually nitroglycerin spray was given in addition to receiving fentanyl. Hemodynamic variables were measured at one minute before and after laryngoscopy. The data was analyzed using SPSS version 19 software. Results: The study data showed that there is no statistically significant difference between the study groups in terms of demographics. Systolic and diastolic blood pressure, as well as heart rate decreased significantly in the group of receiving simultaneous fentanyl and nitroglycerin in comparison to the group receiving fentanyl alone. Conclusions: The results of our study showed that the administration of nitroglycerin spray with fentanyl more weakened the cardiovascular responses induced by laryngoscopy.

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Section: Discussionsupporting

confidence: 93%

Investigating the Effects of Fentanyl and Nitroglycerin on Hemodynamic Changes During Laryngoscopy: A Randomized Trial

Aminisaman,

Nazari,

Aminisaman

et al. 2023

J Clin Res Paramed Sci

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“…Tracheal extubation and emergence from anesthesia may cause dangerous increase in myocardial oxygen demand in patients with coronary artery disease or at risk of developing it [18]. During this study, rate pressure product was high in NTG group as compared to Esmolol group, thus NTG should be cautiously used in coronary artery disease patients [19].…”

Section: Wang Et Al In 2003 Studied Effects Of Different Doses Of IV ...mentioning

confidence: 71%

Efficacy of Intravenous Esmolol With Intranasal Nitroglycerine Spray Given Before Endotracheal Extubation on the Attenuation of Pressor Response: A Comparative Study

Kokate

Mahure

et al. 2023

Asian J Pharm Clin Res

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Aims and Objectives: The aim of the study was to compare the effects of intravenous esmolol and intranasal nitroglycerine spray on attenuation of extubation pressor response in terms of hemodynamic parameters and to compare the adverse effects, if any, of either drug. Methods: This was a randomized comparative study conducted in a tertiary care medical college in which 64 patients of ASA Grade I with age between 18 and 60 years, including both males and females undergoing elective non cardiac surgeries under general anesthesia with orotracheal intubation were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were divided into two groups (Depending on whether they received Intravenous Esmolol or NTG spray) of 32 patients each. Attenuation of extubation pressor response in terms of hemodynamic parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP], heart rate, and rate pressure product) were recorded and compared before induction, during surgery and postoperatively up to 10 min after surgery. Results: The gender distribution was comparable in both the groups. The mean age of patients in Group A and Group B was found to be 36.90±10.12 and 35.20±11.32 years, respectively. The mean age of both the groups was found to be comparable with no statistically significant difference. Both the study groups were comparable in base line parameters with no significant difference seen in mean age, mean heart rate, mean SBP and DBP, MAP, anesthesia time, and surgery time. Both drugs controlled the blood pressure changes effectively; however, NTG group had a better control of systolic as well as DBP. Heart rate was better controlled in esmolol group. Conclusion: Intranasal nitro-glycerine and intravenous esmolol before tracheal extubation in ASA Grade I patients are simple, effective, and practical methods of blunting cardiovascular responses to tracheal extubation.

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“…In a different investigation, Varshney et al examined the pressor response after the administration of GTN and lignocaine spray during direct laryngoscopy and endotracheal intubation (10) . According to the study, The GTN spray was superior to lignocaine at reducing blood pressure increases during elective laryngoscopy and intubation.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of One Glyceryl Trinitarte Spray versus Two Sprays in Attenuation of Pressor Response Following Laryngoscopy and Endotracheal Tube

Jabbar¹,

Ali²

2023

The Egyptian Journal of Hospital Medicine

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Background: Laryngoscopy and tracheal intubation is invariably associated with certain pressor response like hypertension, tachycardia as well as a variation in cardiac arrhythmias. Many pharmaceutical therapies had been applied to attenuate this response with different degree of success. Aims of the Study: To compare the efficacy of one glyceryl trinitarte (GTN) spray versus two sprays in attenuation of pressor response following laryngoscopy and endotracheal tube. Patients and Methods: This is a prospective single observational study including 150 consecutive patients scheduled for elective general surgery under general anesthesia. Control group, group treated with one GTN sublingual spray as (0.4 mg) and group treated with two metered sprays (0.8mg). Heart rate, blood pressure and oxygen saturation values were recorded at baseline (before induction), after induction, 2, 4, 6, 8 and 10 after intubation. Results: SBP, DBP and MAP were significantly reduced in GTN groups (either in one or two sprays) compared to the control group in post induction and at 2 minutes post-intubation (for SBP and DBP) and till 4 minutes post-intubation (for MAP). Furthermore, in post induction and 2 min post intubation. Patients treated with 2 sprays had significantly lower SBP, DBP than those treated with one spray and patients treated with two spray had significantly lower MAP in 2 minutes post intubation than patients treated with one spray. In contrast, HR Post induction and at 2, 4 and 6 min post intubation two sprays group had higher mean HR than control group with significant differences.one spray group had higher mean HR than control group post induction with significant difference. Patients treated with two sprays had higher mean HR than patients treated with one spray at 2 minutes and 4 minutes post intubation with significant difference. Conclusions: The sublingual administration of GTN spray in a dose of 0.4 mg or 0.8 mg prior to intubation in normotensive can attenuate the pressor response to laryngoscopy and intubation. However, one spray GTN is better than two spray considering the attenuation of blood pressure.

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Comparison of Nitroglycerin versus Lignocaine Spray to Attenuate Haemodynamic Changes in Elective Surgical Patients Undergoing Direct Laryngoscopy and Endotracheal Intubation: A prospective randomised study

Cited by 8 publications

References 26 publications

Investigating the Effects of Fentanyl and Nitroglycerin on Hemodynamic Changes During Laryngoscopy: A Randomized Trial

Investigating the Effects of Fentanyl and Nitroglycerin on Hemodynamic Changes During Laryngoscopy: A Randomized Trial

Efficacy of Intravenous Esmolol With Intranasal Nitroglycerine Spray Given Before Endotracheal Extubation on the Attenuation of Pressor Response: A Comparative Study

A Comparative Study of One Glyceryl Trinitarte Spray versus Two Sprays in Attenuation of Pressor Response Following Laryngoscopy and Endotracheal Tube

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