scholarly journals Efficacy of Oral Gabapentin for Attenuation of Haemodynamic Responses to Laryngoscopy & Endotracheal Intubation

2021 ◽  
Vol 10 (12) ◽  
pp. 905-909
Author(s):  
Bhavitha Venigalla ◽  
Sanjot Sudhir Ninave
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Rate Pressure Product ◽  
Marked Rise ◽  
Pressor Responses ◽  
Anaesthesia Practice ◽  
Haemodynamic Changes ◽  
Significant Attenuation ◽  
Random Number Table ◽  
American Society

BACKGROUND Laryngoscopy and endotracheal intubation are basic skills to be acquired by an anaesthesiologist. For many years, laryngoscopy has been used as a conventional way to facilitate endotracheal intubation. These are the most critical events because, they provoke a marked rise in sympathoadrenal response as hypertension and tachycardia. There is an absolute need to decrease these haemodynamic responses, for which various drugs were used, with varying degrees of success. Gabapentin, initially used as an anticonvulsant has extended its role into anaesthesia practice with its multimodal effects. This study was conducted to evaluate the efficacy of oral gabapentin 800 mg in attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation. METHODS After obtaining institutional ethical clearance, a prospective randomised comparative study was undertaken. Written and informed consent was obtained from 80 patients belonging to American Society of Anaesthesiologists (ASA) class I & II scheduled for various elective surgeries under general anaesthesia. They were divided into two groups of 40 each using computer generated random number table. Group G received oral gabapentin 800 mg and group C received empty capsules with sips of water, 2 hours prior to induction. Haemodynamic parameters – heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) were noted and rate pressure product (RPP) was calculated at baseline, at laryngoscopy and then at 1, 3, 5, 10 & 15 minutes after laryngoscopy and endotracheal intubation. RESULTS In Group G there was significant attenuation of HR, SBP, DBP, MAP at 1, 3 and 5 minutes after laryngoscopy and endotracheal intubation as compared to Group C. Hence, in Group G there was significant attenuation of RPP at 1 minute (12673.60 ± 1691.25, 11769.08 ± 1146.02, P = 0.01), 3 minutes (12546.85 ± 1123.78, 11759.98 ± 1358.02, P = 0.01) and 5 minutes (12411.68 ± 1270.04, 11537.03 ± 1230.06, P = 0.002) after laryngoscopy and endotracheal intubation as compared to Group C. No statistical difference was seen at 10 and 15 minutes. CONCLUSIONS Oral gabapentin 800 mg given preoperatively can attenuate haemodynamic responses to laryngoscopy and endotracheal intubation without significant side effects. KEY WORDS Oral Gabapentin, Laryngoscopy, Endotracheal Intubation, Haemodynamic Changes, Attenuation, Pressor Responses

scholarly journals A randomized study of comparison of intravenous dexmedetomidine and intravenous esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation

2020 ◽  
Vol 8 (9) ◽  
pp. 3239
Author(s):  
Ninad Deepak Chodankar ◽  
Bhagyashree Shivde
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Randomized Study ◽  
Cardiovascular Responses ◽  
Pressor Responses ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Group D ◽  
Dexmedetomidine Infusion

Background: The objective of this study was to compare the efficacy of intravenous dexmedetomidine and esmolol in attenuating the cardiovascular pressor responses to laryngoscopy and endotracheal intubation.Method: Study was done on 60 adults, American society of anesthesiologists (ASA) grade I or II normotensive patients, undergoing elective surgery under general anesthesia and willing to participate. These patients were randomly allocated to either group E (esmolol) or D (dexmedetomidine). Group ‘D’, patients were given intravenous dexmedetomidine infusion 1 mcg/kg over 10 minutes, 3 minutes before start of laryngoscopy. Group ‘E’, patients were given intravenous esmolol 1.5 mg/kg 2 minutes before start of laryngoscopy. All patients were premedicated, induced and intubated using thiopentone and succinyl choline as per the protocol. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at baseline (taken half an hour prior to anesthesia), before sedation, after induction but before intubation, immediately after endotracheal intubation and thereafter at 1, 2, 3, 4, 5 and 10 minutes.Results: Immediately after intubation, HR was similar in group D and group E, thereafter HR remained higher in group E as compared to group D, and difference was statistically significant. SBP, DBP and MAP recorded was higher in group E as compared to group D, and difference was statistically significant.Conclusion: Authors conclude that intravenous dexmedetomidine 1 ug/kg is better drug to attenuate hemodynamic response to laryngoscopy and intubation as compared to intravenous esmolol 1.5 mg/kg.

A Comparative Study Between Efficacy Of Esmolol And Lignocaine For Attenuating Haemodynamics Response Due To Laryngoscopy And Endotracheal Intubation

1970 ◽  
Vol 5 (1) ◽  
pp. 25-28 ◽  
Author(s):  
M Begum ◽  
P Akter ◽  
MM Hossain ◽  
SMA Alim ◽  
UHS Khatun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Anaesthetic Management ◽  
Management Plan ◽  
Mean Blood Pressure ◽  
Rate Pressure Product ◽  
Plasma Norepinephrine ◽  
Mean Values ◽  
The Mean

Haemodynamic stability is an integral and essential goal of any anaesthetic management plan. Laryngoscopy and intubation can cause striking changes in haemodynamics. Increase in blood pressure and heart rate occurs most commonly from reflex sympathetic and vagal discharge in response to laryngotracheal stimulation, which in turn leads to increased plasma norepinephrine concentration. This study was designed to compare efficacy of esmolol and lignocaine for attenuating haemodynamics response due to laryngoscopy and endotracheal intubation. The aim of this study was to compare the effects of Esmolol with that of Lignocaine to attenuate the detrimental rise in heart rate and blood pressure during laryngoscopy and tracheal intubation. One hundred and twenty adult patients randomized into group-L and group-E, were received lignocaine 1.5 mg/kg and Esmolol 1.5 mg/kg I.V. respectively. Heart rate and blood pressure in each minutes for the 10 minutes after intubation was recorded. Time span around intubation up to 4 minutes has been looked specifically to isolate the effect of the study drugs at the time of intubation. For statistical analysis Student's 't' test was used for comparing means of quantitative data and chi-square test was used for qualitative data. Difference was considered statistically significant if p<0.05. The mean heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product before starting anesthesia were similar in group-L (Lignocaine group) and in group-E (Esmolol group) (p>0.05). The mean values of heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product at 2, 3 and 4 minutes after intubation were significantly lower in group-E than group-L (p<0.05). In conclusion, esmolol 1.5 mg/kg is superior to lignocaine (1.5 mg/kg) for attenuation of haemodynamic response to laryngoscopy and endotracheal intubation. Key words: Haemodynamics; heart rate; intubation; esmolol; lignocaine DOI: 10.3329/fmcj.v5i1.6810Faridpur Med. Coll. J. 2010;5(1):25-28

scholarly journals Attenuation of extubation responses: Comparison of prior treatment with verapamil and dexmedetomidine

2016 ◽  
Vol 03 (01) ◽  
pp. 033-039 ◽  
Author(s):  
Tuhin Mistry ◽  
Shobha Purohit ◽  
Gunjan Arora ◽  
Nitesh Gill ◽  
Jaya Sharma
Keyword(s):  
Blood Pressure ◽  
Stress Response ◽  
Tracheal Extubation ◽  
Group V ◽  
Airway Response ◽  
Significant Attenuation ◽  
American Society ◽  
Airway Responses ◽  
Group D

Abstract Background: Tracheal extubation is almost always associated with stress response, airway response, and arrhythmias. There are many ways to attenuate this stress response. We have compared verapamil and dexmedetomidine on attenuation of these responses. Materials and Methods: Thirty patients (American Society of Anaesthesiologists Grade I, II) scheduled for spinal surgeries under general anaesthesia were randomly divided into two groups. At the end of surgery, after return of spontaneous efforts (bispectral index >80), in “Group V” verapamil 0.1 mg/kg and in “Group D” dexmedetomidine 0.3 mcg/kg were administered as bolus intravenously over one minute. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded just before (T0) and 2 min after intravenous administration of study medications (TM), just after oral suction (TS), immediately after extubation (TE) and 1, 3, 5 and 10 min postextubation (E1, E3, E5, E10). Duration of emergence and extubation, quality of extubation, Richmond Agitation Sedation Scale (RASS) score and time to reach modified Aldrete score ≥9 were compared. Results: HR, SBP, DBP, MAP were higher in Group V than Group D, but statistically insignificant (P > 0.05). Extubation quality scores was 1 for 20%, 2 for 60% and 3 for 20% patients in Group V, whereas 1 in 80%, 2 in 20% in Group D. There was occurrence of bradycardia within 2 min of administration of drug in one patient in Group D. RASS score was in the range of -1 to +1 in >90% patient in Group V, whereas -3 to -1 in 80% cases in Group D. Conclusion: Single dose of dexmedetomidine (0.3 mcg/kg) given before extubation produced significant attenuation of circulatory and airway responses during extubation as compared to verapamil (0.1 mg/kg).

Attenuation of Cardiovascular Response During Laryngoscopy and Endotracheal Intubation by Using Pethidine with Lignocaine

1970 ◽  
Vol 6 (2) ◽  
pp. 40-43 ◽  
Author(s):  
MT Mollick ◽  
MD Hossain ◽  
NP Ali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Weight ◽  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Cardiovascular Response ◽  
Rate Pressure Product ◽  
Group I ◽  
Blood Pressures ◽  
Group Ii

A prospective comparative study was done on lignocaine versus lignocaine with pethidine to observe the effect on cardiovascular response to laryngoscopy and endotracheal intubation. One hundred such elective surgical patients of active age group (16 - 60 years) having American Society of Anaesthesiologist (ASA) physical status I & II irrespective of surgical procedure were randomly assigned to one of the two groups of 50 each. Group I received injection lignocaine 1 mg/kg intravenously 02 minutes before induction of general anaesthesia. Patients in group II received injection pethidine 1 mg/kg body weight and injection lignocaine 1 mg/kg body weight intravenously 02 minutes before induction of general anaesthesia. Haemodynamic parameter i.e. blood pressures (systolic blood pressure, diastolic blood pressure and mean blood pressure), heart rate, rate pressure product were monitored after 1st, 3rd, 5th minutes following intubation. There were statistically significant (p<0.001) increase in blood pressures, heart rate and rate pressure product in group I i.e. pretreatment with 1 mg/kg body weight intravenous lignocaine and remained so after 5 minutes. On the other hand there were no statistically significant (p>0.05) increase in heart rate, blood pressures and rate pressure product in group II, where pretreatment done with pethidine 1 mg/kg body weight with lignocaine 1 mg/kg body weight and the values returned control level before 5 minutes. The study showed that pethidine 1 mg/kg body weight with lignocaine 1 mg/kg body weight pretreatment suppresses the cardiovascular response due to laryngoscopy and intubation. Key words: Cardiovascular response; laryngoscopy; lignocaine with pethidine. DOI: 10.3329/jafmc.v6i2.7274JAFMC Bangladesh. Vol 6, No 2 (December) 2010 pp.40-43

scholarly journals Comparative Study of “Haemodynamic Changes between Endotracheal Intubations and LMA Insertion”

2009 ◽  
pp. 28-32
Author(s):  
Md Harun-or-Rashid ◽  
ASM Meftahuzzaman ◽  
Manirul Islam ◽  
AKM Aktaruzzaman
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Pulse Rate ◽  
Haemodynamic Parameter ◽  
Card Number ◽  
Haemodynamic Changes ◽  
Group A ◽  
Group B

To compare the haemodynamic changes between LMA insertion & endotracheal intubation, 60 patients were assigned randomly to one of the two groups of thirty each. They were grouped randomly by card sampling. Every patient included in the study was allowed a card preoperatively. According to the card number patients were grouped. Group A. Airway was maintained by LMA. Group B: Airway was maintained by ETT. Haemodynamic parameter i.e. pulse rate, systolic blood pressure, diastolic blood pressure and presence of any dysrhythmia were monitored after 1,3,5 & 10 minutes after LMA insertion or ETT intubations. There was statistically significant changes (P<0.05) in pulse rate, systolic blood pressure, diastolic blood pressure and (appearance of dysrhythmia in some patients) in group ti patients whereas there was less changes in pulse rate, systolic blood pressure, diastolic blood pressure whose airway was maintained by LMA insertion (Group-A). We conclude that LMA insertion causes less Haemodynamic changes than that of endotracheal intubation. So LMA insertion is safer than ETT intubations in some selected patients.   Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.28-32

scholarly journals COMPARISON OF ESMOLOL, LABETALOL AND LIGNOCAINE FOR ATTENUATION OF SYMPATHOMIMETIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Ankit Kumar ◽  
Dr. Arun Kumar Kulshrestha
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Stress Responses ◽  
Left Ventricular ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
American Society ◽  
Group 1

INTRODUCTION: In some individual’s suffering from hypertension, coronary artery disease, cerebrovascular disease, myocardial infarction and thyrotoxicosis, these hemodynamic stress responses can turn into life-threatening conditions like left ventricular failure, myocardial ischemia, cerebral hemorrhage, and ruptured cerebral aneurysm. Different drugs like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α-and β-adrenergic blockers, and opioids can be administered prior to tracheal intubation to prevent hemodynamic responses. But higher dose of lignocaine may lead to hypotension, bradycardia, and hypoxia in patients. Due to various effect of these drugs on hemodynamic changes in patients this study was carried out to evaluate the effects of IV esmolol, lignocaine, and labetalol for attenuation of hemodynamic response to laryngoscopy and intubation. MATERIAL AND METHODS: A total of 90 consecutive patients were included in the study and were grouped in to, lignocaine group, labetalol and esmolol group containing 30 patients each. Age group 21–65 years of either sex or American Society of Anesthesiologists (ASA) Grade I or II scheduled for various general surgical procedures under endotracheal anesthesia were included in this study. Patients excluded were pregnant and lactating women, morbid obesity, and hypertension. RESULTS: Mean Age in Group 1, group2 and group 3 was 40.38 ± 7.25, 43.8 ± 9.24 and 42.56 ± 8.71 respectively while weight was 62.41 ± 7.32, 63.63 ± 8.11 and 60.74 ± 6.92 respectively. There were 17 male and 13 female in group 1, 19 male and 11 female in group 2 and 16 male and 14 female in group 3. Attenuation of blood pressure was more in labetalol group. Reduction of heart rate in labetalol group was significant. It is seen that Labetalol was more effective at attenuation of diastolic blood pressure among all drugs. Mean arterial pressure was not much reduced lignocaine and esmolol group as compared to labetalol. CONCLUSION: Haemodynamic alterations are usually observed during laryngoscopy and endotracheal intubation. In our study it was found that as labetalol is a safe and effective drug, for attenuation of sympathomimetic response.

scholarly journals Comparison of Intravenous Lignocaine and Dexmedetomidine for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation

2021 ◽  
Vol 10 (16) ◽  
pp. 1123-1129
Author(s):  
Deepti N. Anandani ◽  
Manisha S. Kapdi ◽  
Ami D. Patel ◽  
Pratik Jain
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Rate Pressure Product

BACKGROUND The purpose of the present study was to evaluate the efficacy of intravenous lignocaine 1.5 mg / kg & intravenous dexmedetomidine 1 mcg / kg for attenuating the haemodynamic response to laryngoscopy & endotracheal intubation in patients undergoing elective surgery under general anaesthesia. METHODS In this prospective randomised, comparative, clinical study, 60 patients were randomly divided into 2 groups, among them 30 patients were given infusion of 1.5 mg / kg IV lignocaine, diluted to 10 ml with normal saline, 3 minutes before intubation & 30 patients were given infusion of dexmedetomidine 1 mcg / kg diluted to 25 ml in normal saline over 10 minutes through infusion pump before induction. The heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, oxygen saturation were measured at baseline, after study drug intubation at L + 1, L + 3, L + 5, L + 7 & L + 10 (L is onset of laryngoscopy). Statistical analysis was done by using descriptive & inferential statistics using chisquare test, Students paired & unpaired t test to find out the significance of the five variables namely mean heart rate (HR), mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean arterial pressure (MAP) and mean rate pressure product (RPP). RESULTS Dexmedetomidine provided better blunting of stress response during laryngoscopy and intubation without causing clinically significant respiratory depression, bradycardia or hypotension. It is better in achieving a low RPP, which is a good predictor of myocardial oxygen consumption. Dexmedetomidine provides better cardio-protection in patients against pressure response than lignocaine. CONCLUSIONS In these 60 patients, dexmedetomidine (1 mcg / kg) was found to be superior to lignocaine (1.5 mg / kg) for attenuation of pressor response. KEY WORDS Laryngoscopy, Endotracheal Intubation, Dexmedetomidine, Lignocaine, Rate Pressure Product

scholarly journals COMPARISON OF ESMOLOL, LABETALOL AND LIGNOCAINE FOR ATTENUATION OF SYMPATHOMIMETIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. H. Kirankumar
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Stress Responses ◽  
Left Ventricular ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
American Society ◽  
Group 1

INTRODUCTION: In some individual’s suffering from hypertension, coronary artery disease, cerebrovascular disease, myocardial infarction and thyrotoxicosis, these hemodynamic stress responses can turn into life-threatening conditions like left ventricular failure, myocardial ischemia, cerebral hemorrhage, and ruptured cerebral aneurysm. Different drugs like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α-and β-adrenergic blockers, and opioids can be administered prior to tracheal intubation to prevent hemodynamic responses. But higher dose of lignocaine may lead to hypotension, bradycardia, and hypoxia in patients. Due to various effect of these drugs on hemodynamic changes in patients this study was carried out to evaluate the effects of IV esmolol, lignocaine, and labetalol for attenuation of hemodynamic response to laryngoscopy and intubation. MATERIAL AND METHODS: A total of 90 consecutive patients were included in the study and were grouped in to, lignocaine group, labetalol and esmolol group containing 30 patients each. Age group 21–65 years of either sex or American Society of Anesthesiologists (ASA) Grade I or II scheduled for various general surgical procedures under endotracheal anesthesia were included in this study. Patients excluded were pregnant and lactating women, morbid obesity, and hypertension. RESULTS: Mean Age in Group 1, group2 and group 3 was 40.38 ± 7.25, 43.8 ± 9.24 and 42.56 ± 8.71 respectively while weight was 62.41 ± 7.32, 63.63 ± 8.11 and 60.74 ± 6.92 respectively. There were 17 male and 13 female in group 1, 19 male and 11 female in group 2 and 16 male and 14 female in group 3. Attenuation of blood pressure was more in labetalol group. Reduction of heart rate in labetalol group was significant. It is seen that Labetalol was more effective at attenuation of diastolic blood pressure among all drugs. Mean arterial pressure was not much reduced lignocaine and esmolol group as compared to labetalol. CONCLUSION: Haemodynamic alterations are usually observed during laryngoscopy and endotracheal intubation. In our study it was found that as labetalol is a safe and effective drug, for attenuation of sympathomimetic response.

scholarly journals Clinical efficacy of Esmolol, Lignocaine and Diltiazem as premedicant for attenuation of hemodynamic responses of laryngoscopy and endotracheal intubation- a comparative evaluation

2017 ◽  
Vol 5 (10) ◽  
pp. 4443 ◽  
Author(s):  
Chitrangna Gupta ◽  
Bhawana Rastogi ◽  
Salony Agarwal ◽  
V. P. Singh ◽  
Vineet K. Choudhary ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Saline Group ◽  
Rate Pressure Product ◽  
Control Group ◽  
Double Blind ◽  
Maximum Increase ◽  
Group D ◽  
Better Than

Background: Direct laryngoscopy and endotracheal intubation after induction of anesthesia is almost always associated with hemodynamic stress response. The aim of this study was to compare esmolol, lignocaine and diltiazem for suppression of laryngoscopy and intubation response.Methods: This randomized prospective double-blind control study was performed on 120 patients of either sex, aged between 18 and 58 years of ASA physical status I and II with Mallampatti grade I and II, undergoing elective surgeries under general anesthesia with endotracheal intubation. Patients were randomized in four groups, Group N (normal saline), Group E (esmolol) 1.5mg/kg I.V, Group D (diltiazem) 0.2mg/kg I.V, and Group L (lignocaine) 1.5mg/kg I.V with 30 patients in each group. Hemodynamic parameters were recorded during the basal period, preinduction, during intubation and at specified intervals.Results: There was significant increase in systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate in the control group (Group N) in association with tracheal intubation. The heart rate was significantly lower in Group E (Esmolol group), followed by Group D (Diltiazem group) and Group L (Lignocaine group). Rate pressure product was significantly lower in group E as compared to other groups, followed by group D and group L. Maximum increase in rate pressure product (RPP) just after laryngoscopy and intubation was ±74.29% in group N, ±16.11% in group E, 25.38% in group D and 38.77%in group L.Conclusions: Esmolol was better than diltiazem and they both were better than lignocaine for preventing the hemodynamic response after laryngoscopy and intubation.

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

2019 ◽  
Vol 19 (4) ◽  
pp. 316
Author(s):  
Rohit K. Varshney ◽  
Mukesh K. Prasad ◽  
Megha Garg
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Pressor Response ◽  
Surgical Patients ◽  
Rate Pressure Product ◽  
Control Group ◽  
Control Groups ◽  
Treatment Groups ◽  
And Control

Objectives: This study aimed to compare the effects of nitroglycerin (NTG) versus lignocaine spray in blunting the pressor response during direct laryngoscopy and endotracheal intubation. Methods: This study was conducted between January and June 2018 in the Department of Anesthesiology, Teerthankar Mahaveer Medical College, Moradabad, India. A total of 90 elective surgical patients of American Society of Anesthesiologists physical status grades I or II were divided into three groups, comprising two treatment groups and one control group. Patients in the treatment groups received either one puff (1.5 mg/kg) of lignocaine 10% spray or one puff (400 μg) of NTG spray in the oropharynx one minute prior to the induction of anaesthesia. Haemodynamic variables and mean rate pressure product at baseline and one, two, three, four and five minutes post-induction were compared. Results: There was a significant reduction in mean heart rate at 3–5 minutes in both treatment groups compared to the control group (P <0.050), as well as lower increases in mean arterial pressure at 1–3 minutes (P <0.050). However, at 2–4 minutes, there was a significantly greater decrease in mean systolic blood pressure in the NTG group compared to both the lignocaine and control groups (P <0.050). Moreover, a greater decrease in mean rate pressure product response at 1–5 minutes was observed in the NTG group compared to the lignocaine and control groups (P = 0.001). Conclusion: The NTG spray was more effective than lignocaine in attenuating blood pressure increases and rate pressure product during elective laryngoscopy and intubation.Keywords: Endotracheal Anesthesia; Intubation; Laryngoscopy; Lignocaine; Nitroglycerin; Comparative Effectiveness Research; India.

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