Efficacy Of Topical Lignocaine Spray (10%) Applied Before The Induction Of Anaesthesia In Attenuating The Pressor Response To Direct Laryngoscopy And Endotracheal Intubation In Controlled Hypertensive Patients

Jain, Mubarik; Gurcoo, Showkat Ahmad; Qazi, Mohammed Syed; Dar, Bashir Ahmad; Buchh, Velayat N; Ahmad, Sheikh Irshad

doi:10.5580/25bc

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…While in other group they performed only one laryngoscopy and hence noxious stimuli were given twice in the topical group.Mostafa 16 and Hamill 17 in their respective studies had concluded that topical lignocaine is ineffective in preventing the pressor response. Takita etal 18 suggested that differing intervals between tracheal lignocaine and endotracheal intubation probably caused the inconsistent conclusion reported in other investigations and showed that endotracheal intubation performed two minutes after tracheal lignocaine attenuated the cardiovascular responses to endotracheal intubation M. Jain et al 19 performed a study on lignocaine 10 percent spray to study its efficacy in attenuating the pressor response and found it to be effective in attenuating and not abolishing the response, we had similar findings in lignocaine being able to attenuate the pressor response, but they didn't study the optimal timing of the spray and they didn't use glycopyrrolate as a premedication.…”

Section: Discussionmentioning

confidence: 96%

Efficacy and Optimal Time of Oropharyngeal Topical 10% Lignocaine Spray Before Induction of Anaesthesia in Attenuating the Pressor Response to Direct Laryngoscopy and Endotracheal Intubation.

Mushfeen¹

2013

IOSR-JDMS

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The study aimed to ascertain the efficacy of oropharyngeal topical 10% lignocaine spray applied prior to induction of anaesthesia and also to determine the optimal time for spraying to attenuate pressor response to laryngoscopy and endotracheal intubation. 80 patients of either sex, in the age group of 20-60 years (ASA I & II) undergoing different elective surgical procedures under general anaesthesia were taken up for the study. 10 puffs of Lignocaine 10% sprayed 1 min before induction in Group I, 3 min before induction in Group 2, 5 min before induction in Group 3 and normal Saline in Group 4 as control. Heart rate(HR), systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) were measured at baseline, after intubation, after 1min, 3 min and 5 min following intubation. There was statistically significant increase in HR, systolic, diastolic and MAP in control group when compared to baseline as well as to study groups. Following laryngoscopy and intubation attenuation of pressor response did not show a significant difference at 1min, 3min and 5min of 10% lignocaine spray within study groups. Lignocaine 10% when sprayed to the oropharynx prior to induction of anaesthesia attenuated the pressor response to laryngoscopy and intubation irrespective of timing of the spray.

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Section: Discussionmentioning

confidence: 96%

Efficacy and Optimal Time of Oropharyngeal Topical 10% Lignocaine Spray Before Induction of Anaesthesia in Attenuating the Pressor Response to Direct Laryngoscopy and Endotracheal Intubation.

Mushfeen¹

2013

IOSR-JDMS

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“…Hence, Effective attenuation of haemodynamic surge has become an important part in modern anesthesiology and various pharmacological methods have been tried for this. A wide variety of drugs are used to attenuate the hemodynamic response of laryngoscopy and intubation like Lignocaine [4,[6][7][8][9][10][11][12][13][14][15][16][17][18] , fentanyl [19][20][21][22][23] , alfentanyl, ramifentanyl [24] nifedipine [25] , beta blockers like, labetalol [26] , metoprolol, esmolol, gabapentin, pregabalin, magnesium sulphate, ivabradine, dexmedetomidine [27] , cloning [28] . Lignocaine is an aminoethylamide and prototype of amide local anesthetic group.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study on the Efficacy of Lignocaine Nebulisation Vs Topical Lignocaine Spray in Attenuation of Haemodynamic Surge in Patients Undergoing Surgery Under General Anaesthesia - A Single Blinded Randomized Controlled Study

Roy,

Sofiullah,

Bandyopadhyay

et al. 2024

JMSH

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Introduction: Laryngoscopy and tracheal intubation are powerful noxious stimuli that should be attenuated. The present study is to compare the efficacy of lignocaine nebulisation vs topical lignocaine spray in attenuation of haemodynamic surge in patients undergoing surgery under general anaesthesia. Methodology: After ethical committee clearance, a single blind randomized control study was done on sixty patients of either sex aged between 18-55 years of ASA status I undergoing elective surgery under general anaesthesia with endotracheal intubation. Patients were randomly allocated into 2 groups: GROUP A:received nebulised Lignocaine Hydrochloride 4% at 2 mg/kg. GROUP B: received Topical Lignocaine spray 10% at 2mg/kg. Heart rate, Systolic, diastolic and mean blood pressure was documented before administering premedication (T0), at the time of intubation (TI) and at 1min (T-1), 2min (T-2) & 5min (T-5) after intubation. Attenuation in HR, SBP, DBP and MBP were found statistically significant (p<0.05) in group A in comparison to group B. Thus in conclusion Lignocaine nebulisation is far more effective in comparison to topical lignocaine spray in attenuation of the laryngoscopic surge. Results: After conducting the study on a total of sixty patients it was found that there was statistically significant reduction in SBP, DBP, MBP and HR in GROUP A receiving lignocaine nebulisation compared to GROUP B receiving topical lignocaine spray. Conclusion: Lignocaine nebulisation is more effective than topical lignocaine spray in attenuation of haemodynamic surge following laryngoscopy and intubation in patients undergoing surgery under general anaesthesia. Keywords: Laryngoscopy, Tracheal Intubation, Lignocaine Nebulisation, Lignocaine Spray, Heamodynamic Surge

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Attenuation of Hemodynamic Response to Direct Laryngoscopy and Intubation Using 10% Lignocaine Spray : A Clinical Study

Manjunath¹,

Ravi²

2015

jemds

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Hemodynamic response to Laryngoscopy and Intubation is a well-known problem since long time and there are many studies conducted to attenuate this presser response, the present study is undertaken to study the effect of 10% lignocaine spray for suppressing the cardiovascular responses to tracheal intubation. METHODS: Thirty nine Patients of either sex aged between 20-60years of age, belonging to ASA Grade I and II, undergoing elective surgery requiring General Anesthesia with endotracheal intubation were included for the study. After recording the baseline Heart Rate, Systolic Blood Pressure and Diastolic Blood Pressure lignocane spray 10% meter dose was used to anaesthetise glasoepiglotic fold before premedication. Anaesthesia induced with propofol and succinylcholine to assist direct laryngoscopy and intubation. Heart rate, systolic blood pressure, diastolic blood pressures were recorded after premedication, induction and immediately after intubation. RESULTS: Heart Rate, Systolic blood Pressure, Diastolic Blood Pressure and rate pressure product of 39 patients included in the study were analyzed and compared from baseline parameters to after intubation. CONCLUSION: Study concluded that 10% lignocaine spray is a simple and probably one of the most effective methods in attenuating hemodynamic response to laryngoscopy and intubation. KEYWORDS: Haemodynamic response, Laryngoscopy and intubation, 10% lignocaine spray. INTRODUCTION:Direct laryngoscopy and intubation leads to reflex release of catecholamines resulting in hemodynamic response meaning transient increase in heart rate, systolic blood pressure, diastolic blood pressure, (1)(2) and occasionally cardiac arrhythmias. (3) It is a self-limiting in most of the patients however it can leads to morbidity and mortality in patients having coronary artery disease and raised intracranial tension. (4)(5) Hence many attempts have been made to attenuate this presser response. Although this hemodynamic response is due to sympathetic adrenergic reflex to laryngoscopy and intubation, most of the studies or the approach using different agents are aimed at blocking the effect of the reflex rather than preventing the stimulation starting from inducing agents thiopentone, propfol (6) analgesics, (7) different opioids, (8)(9) beta blockers, (10)(11) calcium channel blockers, (12)(13) sodium channel blocker (14) and of late alpha2 agonists. (15) Some attempts made to reduce the stimulation include different techniques of intubation, Blaind oral intubation, (16) fiber optic intubation. (17) Few attempts by anaesthetizing the posterior part of tongue and valecula are also made by nerve block(glossopharyngial, laryngeal and transtracheal nerve) (18)(19) Lignocaine 2% viscus gargling, (20) topical spray 4% (21) and 10% (22) most of the methods used to attenuate the presser responses are effective. This study with lignocaine 10% aerosol metered dose spray is an attempt to provide simple effective and not very expensive method.

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Efficacy Of Topical Lignocaine Spray (10%) Applied Before The Induction Of Anaesthesia In Attenuating The Pressor Response To Direct Laryngoscopy And Endotracheal Intubation In Controlled Hypertensive Patients

Cited by 3 publications

References 15 publications

Efficacy and Optimal Time of Oropharyngeal Topical 10% Lignocaine Spray Before Induction of Anaesthesia in Attenuating the Pressor Response to Direct Laryngoscopy and Endotracheal Intubation.

Efficacy and Optimal Time of Oropharyngeal Topical 10% Lignocaine Spray Before Induction of Anaesthesia in Attenuating the Pressor Response to Direct Laryngoscopy and Endotracheal Intubation.

Comparative Study on the Efficacy of Lignocaine Nebulisation Vs Topical Lignocaine Spray in Attenuation of Haemodynamic Surge in Patients Undergoing Surgery Under General Anaesthesia - A Single Blinded Randomized Controlled Study

Attenuation of Hemodynamic Response to Direct Laryngoscopy and Intubation Using 10% Lignocaine Spray : A Clinical Study

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