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 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 ( = 30) received 4% nebulized lignocaine (3 mg/kg), while Group S ( = 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 < 0.05 considered significant.

RESULTS

Nebulized lignocaine significantly reduced the heart rate ( = 0.008, 0.007), systolic blood pressure ( = 0.03, 0.04), and diastolic blood pressure ( = 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.