Effects of intravenous and inhaled nebulized lignocaine on the hemodynamic response of endotracheal intubation patients: A randomized clinical trial

Abstract

Background:Endotracheal intubation is one of the most common measures in the Intensive Care Unit (ICU) which plays an important role in airway management of the critically ill patients.Aims:The study aimed to evaluate the effects of lignocaine spray on hemodynamic response of endotracheal intubation patients.Settings and Design:This study is a randomized clinical trial on a study population comprising patients admitted to the ICU.Subjects and Methods:The patients were divided into three groups using a permuted block randomization. In Group 1, inhaled nebulized lignocaine 4% (75.0 mg/kg) was sprayed around the patients’ epiglottis and larynx. In Group 2, intravenous (IV) lignocaine 2% (75.0/mg/kg) was injected. No lignocaine was prescribed for or administered to the control group. One and four minutes after intubation, the patients’ hemodynamic and vital signs were measured.Statistical Analysis Used:Data analysis was run using Stata 13 software through repeated measure ANOVA tests.Results:Although the mean arterial blood pressure (MAP) of Group 1 (inhaled nebulized lignocaine) was smaller than that of Group 2 (IV lignocaine), there was no significant difference between the two groups. Both groups’ MAPs were significantly different from that of the control group. As for the average number of pulses, a significant difference was observed between the inhaled and IV lignocaine groups; hence, the average number of pulses in Group 1 (inhalation) was lower than that of Group 2 (IV injection).Conclusion:As blood pressure is considered to be normal under 140/90 and may not entail any hemodynamic complications, it can be concluded that inhaled nebulized lignocaine can control the hemodynamic changes of intubation more effectively than IV lignocaine.

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

“…22 Contrary to our findings, Jokar et al concluded that inhaled lignocaine 4% 75 mg per kg can control hemodynamic response more effectively. 23 Ganesan et al observed that nebulization with 8 mL of 2% lignocaine 20 minutes before laryngoscopy is more effective than i.v. lignocaine.…”