Effects of Intravenous and Inhaled Nebulized Lignocaine on the Hemodynamic Response of Endotracheal Intubation Patients: A Randomized Clinical Trial

BACKGROUND: Endotracheal intubation is one of the most common measures in the Intensive Care Unit (ICU) which plays an important role in airway management of the critically ill patients. AIMS: The study aimed to evaluate the effects of lignocaine spray on hemodynamic response of endotracheal intubation patients. SETTINGS AND DESIGN: This study is a randomized clinical trial on a study population comprising patients admitted to the ICU. SUBJECTS AND METHODS: The patients were divided into three groups using a permuted block randomization. In Group 1, inhaled nebulized lignocaine 4% (75.0 mg/kg) was sprayed around the patients’ epiglottis and larynx. In Group 2, intravenous (IV) lignocaine 2% (75.0/mg/kg) was injected. No lignocaine was prescribed for or administered to the control group. One and four minutes after intubation, the patients’ hemodynamic and vital signs were measured. STATISTICAL ANALYSIS USED: Data analysis was run using Stata 13 software through repeated measure ANOVA tests. RESULTS: Although the mean arterial blood pressure (MAP) of Group 1 (inhaled nebulized lignocaine) was smaller than that of Group 2 (IV lignocaine), there was no significant difference between the two groups. Both groups’ MAPs were significantly different from that of the control group. As for the average number of pulses, a significant difference was observed between the inhaled and IV lignocaine groups; hence, the average number of pulses in Group 1 (inhalation) was lower than that of Group 2 (IV injection). CONCLUSION: As blood pressure is considered to be normal under 140/90 and may not entail any hemodynamic complications, it can be concluded that inhaled nebulized lignocaine can control the hemodynamic changes of intubation more effectively than IV lignocaine.