Hemodynamic response of lignocaine in laryngoscopy and intubation

Abstract

BackgroundLaryngoscopy and tracheal intubation can associate with increased blood pressure and heart rate, increased risk of mortality and morbidity in high risk patients. AimTo compare the hemodynamic changes to direct laryngoscopy and tracheal intubation between intravenous and nebulized forms of lidocaine. MethodsA prospective, double blind and randomized controlled trial was performed in Kasturba Medical College, Manipal. A total of 66 subjects were randomized equally to IV lidocaine and nebulized lidocaine groups. Data was analyzed using IBM SPSS statistical software. ResultsThere was no statistically significant difference in mean arterial BP (MAP) across the groups pre induction. Post intubation difference in MAP was noted between the groups at 1, 2, 3, 4 and 5 min. Proportion of subjects with >25% deviation in heart rate was 63.63%, 45.45% and 68.18% whereas subjects with >25% deviation in MAP was 72.73%, 54.55% and 54.55%in IV and Nebulized lignocaine group respectively. Drop in MAP was observed in 9.09%subjects each in nebulization and IV groups. ConclusionSince no significant differences were observed between IV and nebulized lidocaine groups, clinicians may choose any of the methods, based on the cost and preference, till further evidence is generated.