INTRAVENOUS LIGNOCAIN 2% (PLAIN) EFFICACY IN ATTENUATION OF STRESS RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION WITH IMPACT ON IN-HOSPITAL MORBIDITY AND MORTALITY

Intravenous Lignocain 2% (Plain) in Intubation

Abstract

Objective: To evaluate the efficacy of plain lignocain in attenuation of stress response to laryngoscopy and endotracheal intubation with impact on in-hospital mortality or morbidity.
Study Design: A randomized control trial.
Place and Duration of Study: Our study was carried out from December 2013-14, at tertiary-care hospital.
Material and Methods: Patients (n=100 total) were randomized, using non-probability convenient sampling, dividing the population in two groups. Group A (n=50) as control, and in group B (n=50) Injection lignocain plain 2% @ 1.5 mg/kg was used 3 minutes prior to intubation. Both the groups were observed for changes in hemodynamic parameters i.e. heart rate (HR) systolic and diastolic blood pressure, Mean Arterial Pressure for every minute after baseline (0) and for 5 consecutive minutes (1, 2, 3, 4, and 5). Deviation of >20% from baseline was considered significant. The mortality (death within hospital, irrespective of cause) and morbidity (defined as emergence of 4 condition as hypertensive encephalopathy, Acute Coronary Syndrome, Lab proven Myocardial Infarction and negative pulmonary edema) within 10 days of hospitalization were noted.
Results: Statistically significant (p-value extremely significant at confidence interval of 98 degrees) results were obtained in the effect of study drug; however, 10 days of hospitalization remained inconclusive for emerging morbidity categories strictly due to the intubation reflexes. We consider few technicalities in peri-operative management resulted in such events.
Conclusion: Lignocain is effective in blunting the pressor response towards laryngoscopy and intubation. However the impact on mortality/ morbidity for four conditions remained inconclusive.