Online ISSN: 2515-8260

Keywords : lignocaine


A randomized double-blind comparative study between efficacy of magnesium sulphate 30 mg/kg and 2% lignocaine 1.5 mg/kg in attenuating cardiovascular response to laryngoscopy and endotracheal intubation

Dr. B Sunitha, Dr. T Tejaswini, Dr. G Alekhya, Dr. P Sateesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2788-2793

The standard technique of laryngoscopy and endotracheal intubation involves the stimulation of Larynx, Pharynx, Epipharynx and trachea, which are extensively innervated by Autonomic nervous system, namely the parasympathetic innervation via vagus and glossopharyngeal nerves and sympathetic via superior cervical ganglion. All patients were explained in detail about the study and informed consent was taken. Patients were randomly allocated to receive intravenous Magnesium sulphate infusion 30 mg/kg, 15 minutes before induction of anaesthesia or injection Lignocaine 1.5mg/kg intravenously 90 seconds before intubation. All patients had an peripheral intravenous line secured in the pre-operative holding area. Randomization was done by picking lots. The Anaesthesiologist who prepared and administered the drug was not involved with the intra and post-operative management of the patient. We conclude that Magnesium sulphate and Lignocaine are effective in blunting the hemodynamic response to intubation, but Magnesium sulphate is superior to Lignocaine in blunting the hemodynamic response to laryngoscopy and endotracheal intubation without any significant side effects.

Comparison of magnesium sulphate with lignocaine for blunting response to laryngoscopy andintubation

Dr. Swarna Horalali, Dr. Mohan Kumar Ramiah Mahadeva, Dr. Reshma Mulla,Dr. Nataraj MS,Dr. CGS Prasad

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1201-1210

Background:Haemodynamic changes occurring during direct laryngoscopy and endotracheal
intubation are well tolerated by healthy individuals but can be fatal in patients with
hypertension, heart disease and intracranial hypertension. Many methods have been tried to
obtund these responses.
Methods: 60 consenting patients were randomised to receive 30 mg/kg of magnesium
sulphate (MgSO4) in 100 ml saline over 10 min before induction or preservative free 2%
lignocaine 1.5 mg/kg diluted to 5 ml with saline 90 secs before intubation. Heart rate,
systolic, diastolic & mean blood pressures and time taken to extubate were monitored.
Results: Hemodynamic parameters showed no significant rise at intubation in both the
groups. Time taken to extubate was similar in both the groups.
Conclusion: MgSO4 30 mg/kg given intravenously as infusionover 10 minutes prior to
induction and lignocaine 1.5 mg/kg given 90 seconds before intubation were comparable in
attenuating pressor response to laryngoscopy and intubation with no clinically significant
prolongation in time taken to extubate in MgSO4 group.

Comparison of sublingual nitroglycerine spray with oropharyngeal lignocaine spray for blunting response to laryngoscopy and intubation

Dr. Harsha R, Dr. Mohan Kumar Ramiah Mahadeva,Dr. Reshma Mulla,Dr. Nataraj MS,Dr. Manjunatha C,Dr. CGS Prasad

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1218-1226

Background: Endotracheal intubation is a common mode of securing the airway for
administering general anaesthesia. Direct laryngoscopy and endotracheal intubation is almost
always associated with haemodynamic changes due to reflex sympathetic stimulation caused
by laryngopharyngeal stimulation.
Methods: A prospective, randomized controlled clinical study was undertaken to compare
the efficacy of oropharyngeal lignocaine spray (group L,n=30) and sublingual nitroglycerine
spray (group N, n=30) in blunting of haemodynamic response to laryngoscopy and intubation
belonging to ASA I, posted for surgery under general anaesthesia.
Results: There was statistically significant difference in the mean heart rate between the
groups for the first 3 minutes after intubation. Statistical evaluation between the groups
showed the mean SBP was statistically significant (p=0.036) for initial 3 mins after intubation
and also at 5th 6th & 10th minute. Statistical evaluation between the groups showed that
mean DBP 1st minute after intubation was statistically significant (p=0.008). The difference
was significant at 4, 5, 6 and 9 min after intubation. Statistical evaluation between the groups
did not show any statistical difference in the MAP except at 5th & 6th minute. However,
there was no clinically significant difference in any of the above groups.
Conclusion: Both sublingual NTG & lignocaine group successfully blunted the intubation
response, sublingual NTG spray was better in suppressing the BP response to laryngoscopy
and intubation than oropharyngeal lignocaine spray but lignocaine controlled the HR
response better than NTG.