title: Comparison of different doses of intranasal nitroglycerine in attenuation of pressor response to laryngoscopy and intubation.
abstract: OBJECTIVE
  To observe the various pressor responses to laryngoscopy and intubation in normotensive patient undergoing elective surgery under general anesthesia and use of three different attenuating doses (400, 800, 1200 mcg) of intranasal nitroglycerine administered five minutes before laryngoscopy and intubation, to observe the efficacy and safety.
  
  
  METHODS
  Randomized study.
  
  
  METHODS
  The study was carried out in a total of 60 patients. ASA grade 1 and II patients posted for elective surgeries under general anesthesia were included. Patients received different doses of intranasal nitroglycerine five minutes before induction as given below Group 1-received 400 micrograms-20 patients Group 2-received 800 micrograms-20 patients Group 3-received 1200 micrograms-20 patients.
  
  
  METHODS
  Student's t test.
  
  
  RESULTS
  Results were statistically analyzed. All three groups effectively attenuated the pressor response to laryngoscopy and intubation. Maximum rise in heart rate was seen in group III (23.86%). Maximum fall in systolic (19.6%), diastolic (30.76%), and mean arterial blood pressure (25.53%) was observed in group III at 10(th) minute of laryngoscopy and intubation.
  
  
  CONCLUSIONS
  Best results of attenuation of pressor response were seen with 400 and 800 micrograms of intranasal nitroglycerine. One thousand and two hundred micrograms dose caused maximum increase in heart rate and caused maximum fall in blood pressure, hence it is advisable to use increased dose with caution in attenuation of pressor response to laryngoscopy and intubation.
authors.affiliation: Department of Anesthesiology, B. J. Medical College, Civil hospital, Ahmedabad, Gujarat, India.
authors.forename: Atul B
authors.initials: AB
authors.lastname: Vyas
authors.affiliation: Department of Anesthesiology, B. J. Medical College, Civil hospital, Ahmedabad, Gujarat, India.
authors.forename: Indu A
authors.initials: IA
authors.lastname: Chadha
authors.affiliation: Department of Anesthesiology, B. J. Medical College, Civil hospital, Ahmedabad, Gujarat, India.
authors.forename: Prajeesh M
authors.initials: PM
authors.lastname: Nambiar
authors.affiliation: Department of Anesthesiology, B. J. Medical College, Civil hospital, Ahmedabad, Gujarat, India.
authors.forename: Vijeth T G
authors.initials: VT
authors.lastname: Bhat
authors.affiliation: Department of Anesthesiology, B. J. Medical College, Civil hospital, Ahmedabad, Gujarat, India.
authors.forename: Dharmendrasinh D
authors.initials: DD
authors.lastname: Chavada
authors.affiliation: Department of Anesthesiology, B. J. Medical College, Civil hospital, Ahmedabad, Gujarat, India.
authors.forename: Prashant Chhaganbhai
authors.initials: PC
authors.lastname: Sorathiya
keywords: Intranasal nitroglycerine; laryngoscopy and intubation; pressor response