EFFECTS OF LIGNOCAINE NEBULIZATION VS. MCKENZIE TECHNIQUE ON STRESS RESPONSE TO DIRECT LARYNGOSCOPY – A RANDOMIZED DOUBLE BLIND STUDY

Abstract

Introduction - Laryngoscopy and tracheal intubation causes significant sympathetic response resulting in hypertension and tachycardia. A variety of anaesthetic techniques and drugs have been studied and are available to control the hemodynamic response to laryngoscopy and intubation. The present study is performed to compare the hemodynamic changes for lignocaine administered in two forms that is Mckenzie technique and nebulization in patients requiring general anesthesia with endotracheal intubation. OBJECTIVES - To compare the haemodynamic changes to direct laryngoscopy after administering nebulized lignocaine (4%) and Mckenzie technique with (4%) lignocaine in patients scheduled for elective surgical procedures. MATERIAL AND METHODS - After obtaining written informed consent ,120 patients were randomly allocated to one of the two groups. GROUP A – will receive 4% lignocaine (4ml) spray using Mckenzie technique 15 mins before direct laryngoscopy.GROUP B- will receive 4 ml of 4% lignocaine(4ml) nebulization 15 mins before direct laryngoscopy. Hemodynamic changes(Heart rate ,Mean arterial pressure,ECG) will be monitered and documented at 1min,2min,5min,10min,15min,30 min,60min,120min after intubation and 0min,1min,5min,10 min post extubation .Post extubation cough and sore throat will be documented. RESULTS -The study demonstrated that Group A (McKenzie technique) exhibited significantly better control over heart rate and blood pressure compared to Group B (4% lignocaine nebulization) . Specifically, Group A showed a lower heart rate at 1, 5, 10, 15, 30, 60, and 120 minutes post-intubation, with p-values less than 0.05 at each time point, indicating statistically significant differences. Furthermore, SBP and DBP were considerably lower in Group A at multiple time points, indicating a greater dampening of the hemodynamic stress response to intubation in this group. xv CONCLUSION - The McKenzie technique demonstrated superior efficacy in maintaining haemodynamic stability throughout both intubation and extubation phases. Group A, employing the McKenzie technique, consistently exhibited lower, (SBP) systolic and diastolic blood pressures, mean arterial pressures & heart rates compared to Group B, which received nebulized lignocaine. These differences were statistically significant, underscoring the McKenzie technique's ability to mitigate perioperative stress responses effectively.