INTUBATION

COMPARISON OF GLYCERYLTRINITRATE WITH PLAIN LIGNOCAINE IN ATTENUATING THE HYPERTENSIVE RESPONSE.

Abstract

Back ground: Endo-tracheal intubation causes hypertensive stress response and increase in blood
pressure and heart rate. This increase in systolic blood pressure causes myocardial ischemia and dysrythmias in
vulnerable patient . Different drugs 1 are used intravenously to attenuate this hypertensive response during intubation.
I compared glyceryltrinitrate with plain Lignocaine intravenous to obtund this hypertensive stress response. Material
and method. In a randomized, double blind study, 60 patients were selected for this study and divided into two equal
groups of I and II based on receiving intravenous glyceryltrinitate and plain lignocaine respectively. A bolus dose of
Glyceryltrinitrate (Nitronal) 200 μg, 20 seconds before intubation. And then titration at a rate of 2 μgm/kg/minute was
started. Group II was given plain lignocaine 1.5 mg/kg body weight. The comparative study was carried out to know
the effectiveness of each drug to blunt the hypertensive stress response and Heart Rate Variability (HRV) during
intubation. Blood pressure and heart rate variability (HRV) immediately after intubation was assessed. Results: Blood
pressure fall was more marked in patient receiving Glyceryltrinitrate (Nitronal) then those of receiving plain Lignocaine,
but heart rate variability (HRV) was greater in patient receiving Glyceryltrinitrate (Nitronal). Conclusion:
Glyceryltrinitrate (Nitronal) is more effective than plain lignocaine in blunting the hypertensive stress response of
intubation .