Comparison of MAP between sublingual Nitroglycerin spray and normal saline spray in attenuating pressor response to extubation

Abstract

Various methods have been tried to decrease this stressor response to extubation such as non pharmacological methods like using laryngeal mask airway or extubation in deeper planes of anaesthesia and pharmacological methods such as pre-treatment with beta blocker), fentany remifentanil, magnesium sulphate or nitroglycerin. Participants in the study aged 18-60 years, of either gender, belonging to ASA grade I and II, undergoing elective surgery in supine position under general anesthesia with tracheal intubation in tertiary hospital. Mean MAP at the time of reversal (TR) was 95.20+5.68 and at the time of administration of NTG spray (T0) was 96.27+7.48. The MAP increased till 3 minutes when the maximum mean BP was 99.29+4.15. This MAP subsequently reduced gradually till 10 minutes (T10) with the mean being 84.80+2.60. The mean MAP at the time of reversal (TR) was 95.43+3.06 and at the time of administration of saline spray (T0) was 98.1 +3.60. The MAP increased till 4 minutes (T4) when the maximum mean BP was 120.98+2.80. This MAP remained high till 10minutes. This increase in MAP when compared was statistically highly significant with p value of <0.0001.