Assessment of Effect of Nebulised Lidocaine on Haemodynamic Responses during Nasotracheal Intubation

Effect of nebulised lidocaine on haemodynamic responses

Abstract

Background: Aim: To assess the effect of nebulised lidocaine on haemodynamic responses during nasotracheal intubation. Subjects and Methods: Eighty- four patients of American Society of Anaesthesiologists classes I- II age ranged 18-65 years planned for head and neck surgery were randomized into 2 groups based on lottery method. Group I patients were nebulised with 5 ml of normal saline. Group II patients were nebulised with 5 ml (200 mg) of lidocaine 4% (40 mg/ml) solution. Parameter such as systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were observed before and after nebulisation, just before intubation, immediately after intubation and at 3, 5 10 min after intubation. Results: The mean BMI was 25.8 Kg/m2 in group I and 26.2 Kg/m2 in group II. ASA grade I was seen in 32 in group I and 30 in group II and ASA II in 9 in group I and 11 in group II. The mean duration of nasotracheal intubation was 57.2 seconds in group I and 59.4 seconds in group II. The mean SBP (mm Hg) and DBP in both groups were significant statistically (P< 0.05). The mean MAP (mm Hg) at baseline was 95.7 in group I and 92.1 in group II, just before intubation was 82.3 in group I and 76.4 in group II, immediately after intubation was 101.9 in group I and 86.2 in group II, at 3 minutes was 93.2 in group I and 81.7 in group II, at 5 minutes was 89.5 in group I and 84.2 in group II and at 10 minutes was 88.2 in group I and 83.0 in group II. A significant difference was observed (P< 0.05). Conclusion: Administration of nebulised 4% lidocaine inhalation before induction attenuates cardiovascular response and sympathetic stimulation that occurs due to nasotracheal intubation.