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Indian Journal of Applied Basic Medical Sciences
Year : 2017, Volume : 19a, Issue : 28
First page : ( 66) Last page : ( 81)
Print ISSN : 0975-8917. Online ISSN : 2249-7935.

Comparison of different doses of nitroglycerine spray for attenuation of stress response to laryngoscopy

Dr. Panchal Mona, Assistant professor, Dr. Bhatia Upasna*Associate Professor, Dr. Patel Archit, First year Resident, Dr. Bhatia Upasna, Associate Professor

Dept. of Anaesthesia, AMC MET Medical college, LG hospital, Ahmedabad, Gujarat. Ph: +919376163683

*Corresponding author: Email ID: upasna90@gmail.com

Online published on 17 February, 2017.



The study was done to evaluate the efficacy of NTG intranasal spray in attenuation of laryngoscopy and intubation induced hemodynamic responses and to elucidate the optimum dose.

Material and Methods

Prospective randomized controlled study was conducted in 50 ASA physical status I and II patients of both sexes, aged 20–60 years who were scheduled for elective surgery. patients were divided into 2 groups(n=25), group I received 400μg and group II received 800μg intranasally 2 minutes before laryngoscopy and endotracheal intubation after standard general anaesthesia technique and its effects on heart rate, systolic, diastolic, and mean arterial blood pressure were noted before and after premedication and 1–5 minutes after intubation.


Baseline mean heart rate in group I was 97.4 ± 28.91 and 81.80 ± 6.22 in group II. There was highly significant (P <0.01) increase in heart rate as compared to base line values in two groups after laryngoscopy and intubation. There was statistically significant fall in MAP after 30 seconds in Gp I which remained consistently decreased till 5 min post laryngoscopy and intubation. There was 9.97% increase in mean arterial pressure in group II after laryngoscopy and intubation compared to baseline value, and decreased to 4.34% of baseline at 3 min after post-laryngoscopy and intubation.


NTG spray in dose of 400 μg given 2 min before general anesthesia is effective in attenuating the pressor response to laryngoscopy and intubation in normotensive patients, 800 μg does decrease the mean arterial blood pressure but does not have an extra advantage over 400μg. NTG does not attenuate the rise in HR.



Nitroglycerine intranasal spray, General anesthesia, hemodynamic responses.


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