A Comparative Evaluation of Nifedipine and Nitroglycerine in Attenuating the Haemodynamic Response to Laryngoscopy and Intubation

Abstract

Background: Laryngoscopy and tracheal intubation might cause sympathetic response such as hypertension which may be associated with deleterious effects. Thus, prevention and control of these hemodynamic responses are of utmost importance. Nifedipine and Nitroglycerine helps in reducing hypertension.Objective: To study and compare the protective effects of sublingual nifedipine and topical Nitroglycerine on pressor responses to laryngoscopy and endotracheal intubation.Materials & Method: After ethical clearance certification was obtained, 75 female patients with ASA grade I & II, age range between 22 and 55 years enrolled for elective major gynaecological study were selected. Patients were randomly divided into three groups of 25 each, group I: Control group, group II: Nifedipine 10 mg, sublingually 10 minutes before induction and group III: Nitroglycerineoint 2%, 2.5 cm topically applied over forehead, 10 minutes prior to induction. Heart rate and blood pressure were recorded just before laryngoscopy and intubation, just after laryngoscopy and intubation at 1, 2, 3, 5, 10, and 15 minutes on a especially made proforma and electrocardiogram was displayed for any arrythmias.Results: The rise in pulse rate after laryngoscopy and intubation was maximum in 40.38% in control group compared to 34.27% and 34.1% in Nifedipine and Nitroglycerine groups respectively. The systolic blood pressure, diastolic blood pressure and rate pressure product increased significantly after laryngoscopy and intubation in all the three groups, maximum in Control group.Conclusion: We found that Sublingual Nifedipine was found to be superior to topical Nitroglycerine in controlling hypertensive responses to both systolic blood pressure and diastolic blood pressure.