Comparison of Nebulized Lignocaine and Lignocaine Spray for Attenuation of Pressor Response to Laryngoscopy and Endotracheal Intubation: A Randomized Clinical Study

Background: Laryngoscopy and endotracheal intubation trigger significant hemodynamic stress due to sympathetic stimulation. Lignocaine, with its antiarrhythmic and membrane-stabilizing properties, has been explored via different administration routes to mitigate this response, but the optimal route...

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Main Authors: Archana Gautam, Chetan Pande, Meghana Pande, Bhausaheb S. Pawar, Noopur Singh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Journal of Pharmacy and Bioallied Sciences
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Online Access:https://journals.lww.com/10.4103/jpbs.jpbs_487_25
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Summary:Background: Laryngoscopy and endotracheal intubation trigger significant hemodynamic stress due to sympathetic stimulation. Lignocaine, with its antiarrhythmic and membrane-stabilizing properties, has been explored via different administration routes to mitigate this response, but the optimal route remains debated. Objective: This study compared the effectiveness of nebulized lignocaine versus lignocaine spray in attenuating the hemodynamic response to laryngoscopy and intubation in elective surgical patients under general anesthesia. Methods: A randomized study was conducted on 60 ASA I and II patients (18–60 years). Group N (n = 30) received 4% nebulized lignocaine (3 mg/kg), while Group S (n = 30) received 10% lignocaine spray (10 mg/puff) before induction. Hemodynamic parameters were recorded at baseline, during laryngoscopy, and post intubation. Statistical analysis was performed using SPSS, with P < 0.05 considered significant. Results: Nebulized lignocaine significantly reduced the heart rate (P = 0.008, 0.007), systolic blood pressure (P = 0.03, 0.04), and diastolic blood pressure (P = 0.015) at different time intervals post intubation compared to the spray group. Both interventions were well tolerated without major adverse effects. Conclusion: Nebulized lignocaine was superior in blunting the pressor response, likely due to enhanced mucosal absorption and airway distribution. Its routine use could improve cardiovascular stability during general anesthesia.
ISSN:0976-4879
0975-7406