Lignocaine Group Research Articles

Comparative evaluation of pain perception following topical application of clove oil, betel leaf extract, lignocaine gel, and ice prior to intraoral injection in children aged 6-10 years: a randomized control study.

BackgroundIn the field of dentistry, topical anesthetics play an important role in reducing pain during needle pricks. The anesthetic property of betel leaves remain unexplored, even though they have been widely used for the treatment of various ailments. The purpose of this study was to compare and evaluate pain perception following topical application of lignocaine gel, clove gel, ice, and newly developed betel leaf extract gel during intraoral injection in children.MethodsSixty children aged 6–10 years who met the inclusion criteria were divided into four groups. Topical anesthetic agents, 2% lignocaine (Lox-2% Jelly, Neon, Mumbai, India), 4.7% clove gel (Pain Out Dental Gel, Colgate Palmolive India Ltd, Solan, India), 10% betel leaf extract gel, and ice were applied to each group for one min, followed by administration of infiltration anesthesia. Pain perception was analyzed during needle insertion. The Wong Bakers FACES pain rating scale (WBFPRS) was used for subjective assessment and the Sound, Eye, Motor (SEM) scale for objective assessment. Recorded values were tabulated and subjected to appropriate statistical analysis using SPSS software with a P value set at 0.05.ResultsThe clove oil and betel leaf groups demonstrated the highest WBFPRS scores, followed by the ice and lignocaine groups. The clove, betel leaf extract, and ice groups showed equal and highest SEM scores, followed by the lignocaine group. The mean WBFPRS and mean SEM scores were statistically significant.ConclusionBetel leaf extract gel is effective in reducing pain and can act as an alternative topical anesthetic agent.

Comparison of Ketamine, Lignocaine, and Fentanyl on Dose Requirement of Propofol in Patients Undergoing ERCP: A Randomized Controlled Trial

Introduction: Propofol is the most common drug used for providing sedation due to its short duration of action and early recovery. However, it may be associated with hypotension, desaturations, and bradycardia and does not provide analgesia, due to which various adjuncts are used along with it. Lignocaine decreases the doses of propofol and inhalational agent when used for visceral surgeries. Thus, we conducted a study to compare the dose of propofol along with lignocaine, ketamine, and fentanyl for sedation in endoscopic retrograde cholangiopancreatography (ERCP) procedure. Methods: A total of 105 patients were randomized into three groups. Sedation was provided by intravenous bolus injection of propofol 1 mg/kg in all patients followed by infusion of 0.5 mg/kg/hour. In group K bolus dose of intravenous ketamine was 0.5 mg/kg followed by infusion of 0.3 mg/kg/hour, in group L patients were given intravenous bolus of lignocaine 1.5 mg/kg followed by a infusion of 2 mg/kg/hour, in group F the matched volume of saline and 1 μ/kg fentanyl were administered. Intermittent boluses of propofol were given in all three groups in response to patients’ discomfort evidenced by grimaces, movement, or increase in heart rate or mean arterial pressure by >20% of baseline. The total dose of propofol consumed in the three groups was noted. Results: The total dose of propofol consumed and post-procedure abdominal pain was significantly higher in the fentanyl group but was comparable in lignocaine and ketamine groups. Conclusion: Lignocaine and ketamine were equally effective in deceasing propofol requirement and in preventing post-ERCP abdominal pain.

Attenuation of haemodynamic response to laryngoscopy and endotracheal intubation a comparative study between I.V. labetalol and I.V. lignocaine

One of the most common procedures performed by the anaesthisiologists is the Endotracheal Intubation. During this procedure, hemodynamic changes, which may be rapid and dramatic and adverse to the patient may occur. Lignocaine is an excellent drug for the attenuation of pressor events and Labetalol is a potent antihypertensive drug. 50 patients between the ages 18 to 60 years who were scheduled for various procedures under general anaesthesia with ASA Grade I status were included into the study and divided into 2 groups of 25 each. One group was given intravenous Labetalol 0.75mg/kg 10 minutes before intubation and the other group received intravenous injection of Lignocaine hydrochloride (without preservative) 2% in a dose of 1.5 mg/kg over a period of 10 seconds, before 90 seconds of laryngoscopy and intubation. The parameters were lower in Labetalol group (P<0.05) compared to the lignocaine group. The arterial pressures in the Labetalol group attained basal value, and heart rate nearing basal value. The arterial pressures in the Lignocaine group were slightly higher a than basal values and the heart rate is higher than baseline value.Labetalol given intravenous was more advantageous compared to other methods for attenution of hemodynamic changes after laryngoscopy and intubation as it has a good attenuation of pressor response and heart rate and provides a good intra operative profession against haemodynamics response to surgical stimuli.

Clinical study to compare the effect of intratympanic injection of lidocaine and dexamethasone in tinnitus of cochlear origin

<p class="abstract"><strong>Background:</strong> Due to various aetiologies and the less known mechanism involved in tinnitus no treatment modality gives consistent results. Here, we are comparing the efficacy of intratympanic injections of lidocaine and dexamethasone. </p><p class="abstract"><strong>Methods:</strong> Out of 100 selected patients, consecutive patients who fulfilled the inclusion and exclusion criteria are randomly allocated into one of the 2 study groups (50 members each). Intratympanic injection of lidocaine and dexamethasone are given to respective group weekly for 3 consecutive weeks and response is assessed at 1 month and 2nd month of injection. </p><p class="abstract"><strong>Results:</strong> In our study, maximum patients were in the age group of 56-65 yrs. When the effect of lidocaine and dexamethasone on tinnitus (based on THI-tinnitus handicap inventory questionnaire) is compared, dexamethasone is found to be more efficacious than lidocaine with a p value<0.005. Out of total, 96% of dexamethasone group and 68% of lignocaine group have got improved THI score during second follow up. While assessing the effect of lidocaine and dexamethasone on pure tone audiogram (PTA) it is found that, dexamethasone is showing more improvement when compared to lignocaine (p value<0.05). Regarding the adverse effects of injection, side effect is more with lidocaine (50%) than that of dexamethasone (36%), most common adverse effect which we came across was burning type of pain, followed by giddiness which last only for few seconds. </p><p class="abstract"><strong>Conclusions:</strong> Dexamethasone is effective in reducing the overall THI score hence reduces handicap when compared with that of lidocaine with added advantage on hearing.</p>

Efficacy of Glyceryl Trinitrate Ointment for Perianal- Intrarectal Local Anesthesia in Transrectal Ultrasound- Guided Prostate Biopsy- Compared to Topical Lignocaine

Objective: Anorectal pain and discomfort during transrectal ultrasound (TRUS)-guided prostate biopsy is an important issue of this procedure. Therefore present study was designed to compare whether the use of topical glyceryl trinitrate (GTN) ointment or lignocaine gel is more effective as an adjunct to periprostatic nerve block (PPNB) in reducing pain associated with transrectal ultrasound (TRUS)-guided prostate biopsy. Methods: In all, 120 consecutive patients having their first TRUS-guided prostate biopsy were randomized to receive either 0.4% GTN ointment or 2% lignocaine gel, 10 minutes or 5 minutes respectively before biopsy. All patients had a biopsy preceded by an injection with 5 ml of 2% lignocaine local anaesthesia. Results: A 100-point visual analogue score was used to record overall pain due to the presence of the probe, the biopsy itself and pain after the procedure. There was no significant difference in age, PSA level and prostate volume between the groups. There was a significantly lower mean pain score due to probe insertion, in the GTN than lignocaine group (18.32 vs 37.48, P < 0.001); pain perception was lower for the whole procedure in the GTN group (16.59 vs 35.17, P < 0.001); and was most pronounced in men aged d”65 years (21.45 vs 40.7, P < 0.001). Five patients (8.3%) in the GTN group complained of headache. Conclusion: So it can be concluded that, topical GTN ointment is safe and effective in reducing the discomfort and pain associated with TRUS-guided prostate biopsy, in particular the insertion of the ultrasound probe. It might be of maximum benefit in the younger patient(d”65years). Bangladesh Journal of Urology, Vol. 21, No. 1, January 2018 p.14-19

Surgical Field Quality in Trans-Nasal Endoscopic Surgeries Using Lignocaine Infusion and Dexmedetomidine Infusion. A Prospective Randomized Control Study.

Trans-nasal endoscopic surgery (TNES) is a helpful diagnostic and therapeutic modality in otorhinolaryngology surgeries and requires controlled hypotension for better visualization of the surgical field. Recent literature shows evidence of intravenous Lignocaine infusion to produce the controlled hypotension. The study aims to assess and compare the effects of Lignocaine (LIG) and Dexmedetomidine (DEX) infusion with respect to surgical field quality. 101 Consenting adult patients undergoing elective TNES were double-blinded, randomly allocated in one of the two groups and received either DEX infusion of 0.5ug/kg/hr (n = 51) or LIG infusion of 1.5mg/kg/h (n = 50) after a loading dose. Surgical field score (SVF) as the primary outcome and secondary outcomes such as variations in hemodynamic parameters, the requirement for rescue agents and total blood loss were recorded. Both the groups were comparable with respect to patient demographics, total duration of anesthesia and surgery. SVF scores were significantly better in the LIG group during the first 105min of the surgery (p < 0.05). In response to intubation, hemodynamic parameters were lower in LIG group. The requirement of other adjuvant drugs, total blood loss (166.40ml vs. 251.17ml) and extubation time were also significantly lower in the LIG group. The study concludes that intravenous Lignocaine gives a better surgical field in the first 105min of surgery, comparable hemodynamics and decreased blood loss in patients undergoing TNES as compared to Dexmedetomidine infusion. Hence its role as an agent for controlled hypotension during TNES surgery is promising.

Effect of intravenous lignocaine infusion on the quality of emergence in patients undergoing transsphenoidal resection of pituitary tumors - A prospective, randomized controlled trial.

Background: Emergence from anesthesia is a critical step in patients undergoing transsphenoidal pituitary surgery (TSS). The cough suppressant and anesthetic sparing properties of lignocaine makes it a favorable option for smooth extubation and maintaining stable hemodynamics intraoperatively. We aimed to evaluate the effect of lignocaine infusion on the quality of emergence (QOE) and intraoperative hemodynamics in patients undergoing transsphenoidal resection of pituitary tumors.Methods: Fifty patients scheduled to undergo TSS were randomly divided into ligocaine group (n = 25), receiving 1.5 mg/kg bolus dose of lignocaine followed by continuous infusion of 1.5 mg/kg/h and saline group (n = 25). Patients assigned to the control group received equal volume of saline receiving equal volume of saline. The four emergence parameters (mean arterial pressure [MAP], heart rate (HR), cough, and agitation) were abbreviated into an aggregated score for QOE. Time to emergence and intraoperative hemodynamics were also recorded.Results: The QOE was not found to be different between the two groups (P = 0.294). Lignocaine did not increase the time to emergence (P = 0.166). The intraoperative HR and MAP were comparable between the two groups. A lower minimum alveolar concentration of desflurane was required in lignocaine group during insertion of nasal speculum (P = 0.018) and at the time of seller ridge dissection (P = 0.043) compared to the saline group.Conclusion: Intraoperative lignocaine infusion of 1.5 mg/kg/h did not significantly improve the QOE with respect to hemodynamics, cough, and emergence agitation in patients undergoing transsphenoidal resection of pituitary tumors.

Comparison of intravenous granisetron and intravenous lignocaine to alleviate pain on propofol injection: A double blind, randomized, controlled trial

The objective of the study was to compare effectiveness of intravenous (IV) granisetron (2 milligram) with IV lignocaine (30 milligram) in allaying pain on propofol IV administration measured at 15 seconds after propofol administration. 100 patients of age 18-50 years belonging to American Society of Anesthesiologists (ASA) physical status grades I and II, chosen for elective surgery were randomized to two different groups (group L and group G) of 50 each. Patients of group L received IV lignocaine 30 mg and the other group G received IV granisetron 2 mg as pretreatment, before administration of propofol. Patients were assessed for pain after 15 seconds of IV administration of propofol with McCririck and Hunter scale. Both the pretreatments were found to prevent or decrease the pain on propofol administration. Pain assessed at the end of 15 seconds of propofol administration, showed that 76% in lignocaine group &amp; 62%in granisetron group were not having any pain, 12% in lignocaine group and 20% in granisetron group had mild pain, and 12% in lignocaine group and 18% in granisetron group had moderate pain as assessed with McCririck and Hunter scale. There was no significant difference in the pain scores between the groups (χ2 = 2.310, P= 0.315). Both IV granisetron (2 mg) and IV lignocaine (30 mg) are equally effective in allaying pain on propofol injection.

Palonosetron Pretreatment is not as Effective as Lignocaine for Attenuation of Pain on Injection of Propofol.

Objective5-HT3 receptor antagonists are known to possess local anesthetic properties and are commonly used for the alleviation of pain following propofol injection. Palonosetron, a newer molecule, has shown contradictory results for this property. The aim of this study was to compare the effect of palonosetron pretreatment in alleviating propofol injection pain with that of lignocaine. Their comparative effect on various hemodynamic parameters was also evaluated.MethodsA total of 100 adult patients were randomly assigned to one of two groups: group L received lignocaine 40 mg in 5 mL of 0.9% saline pretreatment solution and group P received 0.075 mg palonosetron in 5 mL 0.9% of saline pretreatment solution. After 2 minutes, the tourniquet was released and one-fourth of the total calculated dose of propofol was administered, after which the pain assessment was made. The Students t-test was used for comparing the difference of mean between the two groups after testing for equality of variance using F-statistics. Categorical variables were expressed as a percentage, and the Chi-square test was performed to assess the independence of attributes. Repeated-measure analysis of variance was used to compare the change in heart rate and mean arterial pressure over three time points between the two groups.ResultsThe proportion of pain reported by the subjects in the lignocaine group was significantly lower as compared to the subjects in the palonosetron group (p=0.001). No significant difference of mean heart rate and mean arterial pressure was observed between the two groups following these interventions.ConclusionThe efficacy of palonosetron in alleviating the pain on injection of propofol was significantly less than that of lignocaine.

Prevention of Succinylcholine Induced Postoperative Myalgia by Pretreatment with Lignocaine: A Randomized Controlled Study

Succinylcholine, a depolarizing muscle relaxant possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects such as fasciculation and myalgia. The aim of this study was to investigate the prophylactic effect of intravenous lignocaine on the incidence and severity of succinylcholine-induced postoperative myalgia. This was a randomized controlled double blind study conducted at National Institute of ENT Dhaka, during September to December 2017. Eighty adult patients of American Society of Anesthesiologists status I and II of both sexes for elective surgery under general anesthesia were randomly allocated into two equal groups, lignocaine group and normal saline group. The patients of lignocaine group were pretreated with lignocaine 1.5 mg/kg body weight in 5 ml volume, while patients of normal saline group were given isotonic saline 0.9% in the same volume (5 ml) intravenously. Thereafter, anesthesia was induced in all patients, by injecting 1.5 mg/kg of fentanyl and 2 mg/kg of propofol intravenously. Following the loss of eyelid reflex, 1.5 mg/kg of succinylcholine was injected intravenously as a muscle relaxant and then the patients were intubated. The incidence and severity of myalgia were assessed by a blinded observer 24 hours after surgery. In terms of demographic data, the results of this study showed that there is no significant difference between patients in both groups (P&gt;0.05). Overall, the incidence and severity of succinylcholine-induced myalgia in lignocaine group was significantly less, when compared with normal saline group (P&lt;0.05). Pretreatment with intravenous lignocaine is effective in prevention of postoperative succinylcholine induced myalgia. Faridpur Med. Coll. J. Jan 2019;14(1): 13-15

Hemodynamic response of lignocaine in laryngoscopy and intubation

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.

Effects of nitroglycerine spray and lignocaine spray on the hemodynamic responses to laryngoscopy and endotracheal intubation: A comparative study

BACKGROUND: Laryngoscopy and tracheal intubation cause hypertension and tachycardia in anesthetized patients, which is undesirable, especially in patients with cardiovascular or neurosurgical diseases undergoing anesthesia. Various drug regimens and techniques have been used from time to time for attenuating the pressor response to laryngoscopy and tracheal intubation. The aim is to study, evaluate, and compare the efficacy of nitroglycerine (NTG) spray and 10% lignocaine spray in the attenuation of hemodynamic responses to laryngoscopy and endotracheal intubation and to observe and evaluate any side effects if any associated with the use of these drugs and their management. MATERIALS AND METHODS: This study was conducted on ninety patients under the American Society of Anesthesiologists (ASA) I and ASA II scheduled for elective surgeries. The patients were divided randomly into equal groups of 30 patients and received the following drugs before induction of general anesthesia: Group N-30 patients will be given NTG sublingual spray (2 puffs) 800 mcg 60s before laryngoscopy and group L-30 patients will be given lignocaine spray (2 puffs) 20 mg 60s before laryngoscopy. Hemodynamic variables were continuously recorded from baseline until 15 min after intubation and statistically analyzed. RESULTS: The demographic profile was comparable. The heart rate (HR) increased in both groups, although the increase in HR in the lignocaine group is higher than the increase in HR in NTG group. There was a significant difference in HR values immediately after intubation, 1, 3 min, and 5 min after intubation when the values were lower in group N, and the difference was statistically significant (P 0.05). There was a significant difference in systolic blood pressure (SBP) values immediately after intubation, 1, 3, and 5 min after intubation when the values were lower in group N and the difference was statistically significant (P 0.05). At 1, 3, and 5 min after intubation, the SBP values were significantly higher than baseline in the lignocaine group. However, there was a downward trend in SBP observed in the NTG group until 5 min after intubation, and it was statistically significant. There was a significant difference in diastolic blood pressure (DBP) values immediately after intubation, 1, 3 and 5 min after intubation when the values were lower in group N and the difference was statistically significant (P 0.05). The increase in mean DBP observed in the lignocaine spray group was statistically highly significant when compared to the increase in mean DBP in the NTG spray group. There was a significant difference in mean arterial pressure (MAP) values immediately after intubation, 1, 3 and 5 min after intubation when the values were lower in group N and the difference was statistically significant (P 0.05). NTG spray decreases the MAP more effectively as compared to lignocaine following laryngoscopy and endotracheal intubation. CONCLUSION: Based on our study, we conclude that: In lignocaine spray group patients who received a dose of 20 mg (2 puffs), there was a significant rise in HR, SBP, DBP, mean arterial blood pressure. In the NTG spray group patients who received a dose of 800 mcg (2 puffs), there is effective attenuation of the pressor response to laryngoscopy and intubation in normotensive ASA I–II patients. However, NTG is not able to attenuate the rise in HR due to reflex tachycardia due to vasodilation. Thus, it can be a better alternative in attenuating the hemodynamic responses to laryngoscopy and intubation.

Effect of small-dose ketamine in the prevention of pain on propofol injection: A prospective randomized controlled study

Background: Propofol is a commonly used intravenous anesthetic agent that produces pain when used for induction. In this study, small doses of ketamine are being used in comparison with lignocaine and placebo for alleviating pain on propofol injection. Aims and Objectives: The aim is to assess the effect of ketamine to prevent the pain on injection of propofol and to establish an optimal dose for this purpose. Materials and Methods: We conducted a prospective randomized double-blinded study (placebo controlled) in 160 patients belonging to the American Society of Anaesthesiologists grade 1 and 2 who were posted for elective surgeries to be done under general anesthesia. They were allocated randomly into five groups. Patients were administered normal saline (NS) (Group NS), lignocaine 1.5 mg/kg (Group lignocaine), ketamine 0.1 mg/kg (Group KT1), ketamine 0.3 mg/kg (Group KT2), and ketamine 0.5 mg/kg (Group KT3) just before injection of 1% propofol in a dose of 2.5 mg/kg. Pain scores of patients were assessed at intervals of 10 s by an anesthesiologist who was blinded to the test drug. Efficacy of the pretreatment drug was assessed based on pain score and the occurrence of pain. Results: The occurrence and intensity of pain were significantly higher in the placebo group (Group NS) compared to other study groups. The occurrence of pain and pain scores were lower in the KT2 and KT3 groups compared with the KT1 and lignocaine groups. Conclusion: This study concluded that ketamine administration in a dose of 0.3 mg/kg before propofol injection is beneficial and safe in preventing pain caused by injection of propofol.

Can single buccal infiltration with 4% articaine induce sufficient analgesia for the extraction of primary molars in children: a systematic literature review.

This systematic review aims to determine if a single buccal infiltration (without palatal infiltration in the maxilla and Inferior Alveolar Nerve Block in the mandible) with 4% articaine can induce adequate analgesia for the extraction of primary molars (Maxillary and Mandibular) in children. PubMed, Ovid SP, and Embase were searched for studies published between January 1990 and March 2020 with the relevant MeSH terms. Titles and abstracts were screened preliminarily, followed by the full-texts of the included studies. Five articles were included for this systematic review. The outcome investigated was “Procedural pain during the extraction of primary molars after injection with single buccal infiltration of 4% articaine in comparison to single buccal infiltration, double infiltration (buccal and palatal/lingual), and inferior alveolar nerve block with 2% lignocaine.” Of the five studies that evaluated subjective pain during extraction, two reported no significant difference between the articaine and lignocaine groups, and the remaining three reported lower subjective pain during extraction in the articaine group. Only two studies evaluated objective pain scores during extraction, and both studies reported lower pain scores in the articaine group. There is insufficient evidence to justify the statement that a single buccal infiltration of 4% articaine alone is sufficient for the extraction of primary molars. Further evidence is required to justify the claim that palatal infiltrations and IANB can be replaced with the use of 4% articaine single buccal infiltration for the extraction of primary molars in children.

Single buccal infiltration of high concentration lignocaine versus articaine in maxillary third molar surgery

BackgroundThis research evaluated the numbness produced by lignocaine at an equal or higher concentration than that of 4% articaine through a single point of injection for maxillary third molar surgery. This randomized double-blind study was conducted to compare the anesthetic efficiency of 4% lignocaine with that of 4% articaine in impacted maxillary third molar surgery using a single buccal infiltration alone.MethodsThe study participants were 30 healthy patients requiring the bilateral surgical removal of symmetrically-positioned maxillary third molars. Using a split-mouth design, each patient randomly received buccal infiltration of 1.7 ml of 4% lignocaine and 1.7 ml of 4% articaine during two separate appointments. After 15 minutes of anesthetic injection, surgery was performed by the same surgeon using a consistent technique on both sides. Pinprick test pain scores of the buccal and palatal gingiva of the maxillary third molar after 10 minutes and 15 minutes latencies, pain scores during the surgery, the need for supplemental anesthesia, and patients' satisfaction with anesthetic efficiency were recorded. Surgery performed without supplemental anesthesia was categorized as successful.ResultsThe success rates of 4% lignocaine and 4% articaine (83.34% vs. 86.67%, P = 1.00) were not significantly different. Only 5 cases (4 cases in the articaine group and 1 case in the lignocaine group) reported mild pain and pressure sensation (NRS ≤ 1) on probing at the palatal side after 15 minutes of latency (P = 0.25). The pain scores of maxillary third molar surgery in the two groups were not significantly different (P > 0.05). Moreover, the statistical analysis confirmed the comparable patient satisfaction of two study groups (P = 0.284).ConclusionThis study provides evidence that single buccal infiltrations of 4% lignocaine and 4% articaine have comparable anesthetic efficacy and success rates for impacted maxillary third molar surgery. Both 4% lignocaine and 4% articaine can produce effective palatal anesthesia and pain control using buccal infiltration alone after 15 minutes of latency.

Comparison of efficacy of Lignocaine 1.5 mg/kg &amp; Dexmedetomidine 1 μg/kg in attenuating the hemodynamic pressure response to laryngoscopy &amp; intubation

Background: Dexmedetomidine attenuates the hemodynamic stress response tolaryngoscopy and intubation more effectively compared with Lignocaine without any deleterious effects. To study the efficacy of Lignocaine 1.5 mg/kg & Dexmedetomidine 1 μg/kg in attenuating the hemodynamic pressure response to laryngoscopy & intubation. Material and Methods: A total of 100 American Society of Anesthesiologists (ASA) physical status I and II patients aged between 18 and 50 years undergoing elective surgery were enrolled in the study. Patients posted for elective surgery were randomly selected and divided into two groups. Group L = 50 Patients had given 1.5mg/kg Lignocaine; Group D = 50 Patients had given 1µg / kg Dexmedetomidin. Results: In Dexmedetomidine group, HR, SBP, DBP and MAP showed significant decrease throughout the study period, as compared to Lignocaine group. The statistical analysis shows that, in Dexmedetomidine group, HR, SBP, DBP and MAP showed significant decrease throughout the study period, as compared to Lignocaine group. Conclusion: Newer agents like Dexmedetomidine, a centrally acting alpha-2 agonist suppresses reflex sympathetic stimulation caused by laryngoscopy & intubation more effectively than Lignocaine. Thus, it is concluded that Dexmeditoedine is a better drug compared to Lignocaine in attenuating pressure response to laryngoscopy & intubation.

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

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.&#x0D; 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.&#x0D; 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.&#x0D; 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.

Evaluation of analgesic and hemodynamic efficacy of ephedrine versus lignocaine during propofol injection

ObjectivesTo compare the efficacy of lignocaine and ephedrine in preventing pain and adverse haemodynamic profile associated with propofol injection. MethodsAfter obtaining Instituitional Ethics Committee approval and written informed consent from patients, 180 adult patients of ASA grade I/ II undergoing day care surgery were recruited for the study. The pain scores was explained to them. They were randomised into 3 groups- Group C (Control group); Group L (Lignocaine); Group E (Ephedrine). Baseline haemodynamic parameters (pulse, systolic, diastolic and mean blood pressure) were recorded. Standard premedication were administered intravenously. Propofol infusion was administered at a predetermined standard rate via infusion pump in all the three groups. The study drug was prepared and administered by a separate infusion pump at a calculated rate. The subject was asked to rate the pain sensation till loss of eyelash reflex and the total volume of propofol consumed was calculated. Haemodynamic variables were recorded at one minute interval till 10 minutes from the start of induction. All statistical analysis was done using standard tests. A difference of 30% reduction in pain was considered significant. In order to obtain a 90% power of study and to exclude dropouts sixty patients in each group were considered adequate. ResultsThe number of patients having mild to moderate pain was comparable between ephedrine and lignocaine groups. No patient experienced severe pain. Ephedrine maintained better haemodynamic profile than lignocaine. ConclusionEphedrine when combined with propofol decreases the adverse effects of pain and hypotension.

Effect of 2% Lignocaine Solution in Pain During Removal of Nasal Pack

Background: Nasal packing is commonly done after septal surgeries. Nonabsorbable nasal pack is used to minimize bleeding from surgery site, support the mucoperichondrial flaps, and minimize the risk of formation of septal hematomas and adhesions. However, these materials cause pain and discomfort in-situ as well as during removal. This study was done to evaluate the effect of 2% lignocaine rehydration of nasal pack on pain during pack removal.&#x0D; Methods: This prospective study was conducted on 60 patients who had undergone septoplasty. The patients were divided into 2 groups: Lignocaine and Normal saline group, with 30 patients each. In the Lignocaine group, 2.5 ml of 2% of lignocaine was diluted with 2.5 ml of distilled water and was injected into the nasal pack; and in Normal saline group, 5 ml of normal saline was injected into the nasal pack. Nothing was injected to the left nostril, which acted as a control, in both groups. All patients were asked severity of pain during removal of nasal packing by VAS.&#x0D; Results: In lignocaine group, mean pain score was 3.73 ± 1.63 on lignocaine side and 6.23 ± 1.69 on control side (U=109.5, p&lt;0.001). In Normal saline group, it was 6.5 ± 1.7 on normal saline side and 6.23 ± 1.96 on control side (U=425.5, p=0.711). On comparing VAS between lignocaine and normal saline group, pain was significantly lower in the lignocaine group (U=112.5, p&lt;0.001)&#x0D; Conclusion: Rehydrating nasal pack with 2% topical lignocaine is a useful method to reduce pain during nasal pack removal.

Eutectic mixture of Prilocaine and Lignocaine (2.5%) versus 5% Lignocaine versus placebo for pain relief in new-borns undergoing venipuncture: a hospital based, double blind randomised case control study

Background: Venipuncture is one of the most common cause of iatrogenic pain in neonates which is equally stressful to the parents as well as to the personnel performing the procedure. Despite an abundance of data that demonstrate the efficacy of local anesthetics for reducing venipuncture pain in neonates their use in day to day practice is not used widely used. Our objective was to evaluate the efficacy of EMLA cream and 5% Lignocaine cream versus placebo for pain relief in newborns undergoing venipuncture.Methods: Present study was a hospital based, double blind randomised, case control study. A 240 eligible new-borns were randomised into EMLA, 5%lignocaine and placebo groups after randomization. The respective creams were applied 1 hour before the procedure and pain scores were assessed using NIPS scoring during venepunture. Data was analysed using SPSS ver. 20.0 statistical package. Student’s unpaired t-test and paired t tests was used to compare continuous data, and to compare pain scores one-way ANOVA was used to compare categorical data. A p-value &lt;0.05 was considered statistically significant.Results: Paired t-tests revealed significant lower NIPS scores in EMLA and 5% lignocaine group than the placebo group (p value=0.001).Conclusions: From present study it can be concluded that both EMLA and 5% lignocaine are equally efficacious and cost effective in reducing the pain of venepuncture in neonates.