Comparison of Hemodynamic Changes to Nasal Application of Lignocaine Jelly versus Lubricant Gel and Responses to Ryle's Tube Insertion Following Their Use in Patients Under General Anesthesia

BACKGROUND: Awake patients complain of burning sensation following nasal application of lignocaine jelly. AIM OF THE STUDY: The aim of the study was to assess hemodynamic changes, ease of insertion, number of attempts taken, and time required for insertion of Ryle's tube following nasal application of 2% lignocaine jelly versus lubricant gel in patients undergoing surgeries under general anesthesia. SETTINGS AND DESIGN: This was a prospective, randomized, open-label study conducted in a tertiary care institute. SUBJECTS AND METHODS: Eighty patients undergoing surgeries under general anesthesia who required insertion of a Ryle's tube were included. In Group A, 2% lignocaine jelly was used, whereas in Group B, lubricant gel was used prior to Ryle's tube insertion, after induction of anesthesia. Hypertension and/or tachycardia were managed by increasing sevoflurane by 0.5%–1%, followed by propofol bolus of 0.5 mg.kg(−1). STATISTICAL TESTS USED: Chi-square test and Independent samples t test. RESULTS: Both heart rate and mean arterial pressure were significantly higher at 1 min after nasal application of lignocaine jelly and 1 and 5 min after Ryle's tube insertion in Group A compared to Group B. Ease of insertion of Ryle's tube, number of attempts, and time taken for insertion were comparable in both groups. Significantly higher number of patients in Group A required sevoflurane to be increased and needed propofol boluses. CONCLUSION: Use of lubricant gel for aiding insertion of Ryle's tube in patients under general anesthesia was associated with attenuated heart rate and blood pressure responses without affecting the ease, number of attempts, or time taken for successful insertion of the Ryle's tube.