Publication: The effects of topical lignocaine spray on intubating conditions during induction of anaesthesia with target controlled infusion (TCI) remifentanil and propofol – randomised clinical trial Hospital Universiti Sains Malaysia
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Date
2022
Authors
Khan, Sadia Naim
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Abstract
Background: Neuromuscular blocking agents (NMBAs) are still considered crucial in order to produce optimal intubating conditions. However, there is an ongoing interest for alternative intubation techniques without NMBAs using target-controlled infusion (TCI) remifentanil with other adjunct drugs. The aim of this study was to evaluate the effect of combination of topical lignocaine spray and TCI remifentanil and propofol on endotracheal intubating conditions without NMBAs. Methodology: 60 adult patients of ASA I and II, aged 18 to 65 years, who were electively scheduled for general anaesthesia (GA) underwent induction with TCI remifentanil 4 ng/ml and propofol 4 μg/ml, were randomised into two groups; Group TL (n=30) received 10 puffs (0.1ml per spray) of 10% lignocaine spray in the oral cavity, whereas Group NS (n=30) received the same amount of normal saline, 3 minutes prior to induction. The intubating conditions were assessed upon laryngoscopy using C-Mac video-laryngoscope. Post intubation haemodynamic changes and percentage of patients required rescue NMBAs were recorded. Results: Group TL showed significant higher percentage of easy laryngoscopic procedure [96.7% vs. 56.7%; p<0.01] and open vocal cord position [86.7% vs. 56.7%; p=0.028] than Group NS. However, there were no significant differences in overall intubating condition, requirement of rescue NMBAs and haemodynamic changes between the two groups. Conclusion: Topical lignocaine spray improved laryngoscopic procedure and open vocal cord position during intubation using TCI remifentanil and propofol without NMBAs.
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Keywords
neuromuscular blocking agents , target-controlled infusion – (TCI)