Page No. 128-131
Efficacy of intravenous nitroglycerine in attenuation of hemodynamics to laryngoscopy and intubation
Authors: T. Mohan Singh, Srivani M
Number of views: 396
Background: Different techniques with different drugs have been suggested to attenuate haemodynamics in responses to
laryngoscopy and intubation. Some of these are: topical and intravenous lignocaine, deep inhalational anesthesia, ganglion blockers,
pre-cauterization, narcotics, adrenoceptor blocking drugs, vasodilator, nitroglycerine ointment, and intra-nasal nitroglycerine,
calcium channel blockers, reducing duration of direct laryngoscopy to less than 15 seconds, and avoiding laryngoscopy and
resorting to blind nasal intubation.
Objective: To evaluate efficacy of intravenous nitroglycerine to attenuate hemodynamics to laryngoscopy and endotracheal
intubation in healthy, normotensive ASA grade I patients.
Methods: A prospective study was undertaken for a period of two years. Institutional Ethics Committee permission was obtained.
80 patients with ASA grade me, scheduled for elective surgery under general anesthesia, aged between 20-40 years old, of either
sex, and were included in the study after obtaining their informed and written consent. These 80 patients were randomly allocated
to a study and a control group, (no = 40, each). The study group received intravenous nitroglycerine in the dose of 2.5 to 5
mcg/minute titrated till 5 minutes before intubation.
Results: There was an increase in hemodynamic parameters, which was less in the study group than in the control group, however
still significantly to both groups. The values of pulse rate, blood pressure and rate pressure product returned to basal levels at the
end of third minute in the study group; whereas in the control group it lasted for more than five minutes.
Conclusion: The present study established the usefulness of the intravenous nitroglycerine to attenuate hemodynamics to
laryngoscopy and tracheal intubation. No side effects were noted with nitroglycerine in the present study.