Skip to main content Accessibility help

Effects of lignocaine on pressor response to laryngoscopy and endotracheal intubation during general anaesthesia in rigid suspension laryngoscopy

  • I S Kocamanoglu (a1), S Cengel Kurnaz (a2) and A Tur (a1)



This study aimed to compare the effects of topical and systemic lignocaine on the circulatory response to direct laryngoscopy performed under general anaesthesia.


Ninety-nine patients over 20 years of age, with a physical status of I–II (classified according to the American Society of Anesthesiologists), were randomly allocated to 3 groups. One group received 5 ml of 0.9 per cent physiological saline intravenously, one group received 1.5 mg/kg lignocaine intravenously, and another group received seven puffs of 10 per cent lignocaine aerosol applied topically to the airway. Mean arterial pressures, heart rates and peripheral oxygen saturations were recorded, and changes in mean arterial pressure and heart rate ratios were calculated.


Changes in the ratios of mean arterial pressure and heart rate were greater in the saline physiological group than the other groups at 1 minute after intubation. Changes in the ratios of mean arterial pressure (at the same time point) were greater in the topical lignocaine group than in the intravenous lignocaine group, but this finding was not statistically significant.


Lignocaine limited the haemodynamic responses to laryngoscopy and endotracheal intubation during general anaesthesia in rigid suspension laryngoscopy.


Corresponding author

Address for correspondence: Dr Senem Cengel Kurnaz, Ondokuz Mayis Universitesi, Tip Fakultesi, KBB Anabilim Dali, Kurupelit 55139, Samsun, Turkey Fax: 00-90-362-4576041 E-mail:


Hide All
1Strong, MS, Vaughan, CW, Mahler, DL, Jaffe, DR, Sullivan, RC. Cardiac complications of microsurgery of the larynx: etiology, incidence and prevention. Laryngoscope 1974;84:908–20
2Sun, HL, Wu, TJ, Ng, CC, Chien, CC, Huang, CC, Chie, WC. Efficacy of oropharyngeal lignocaine instillation on haemodynamic responses to orotracheal intubation. J Clin Anesth 2009;21:103–7
3Kocamanoglu, IS, Sener, EB, Ustun, E, Tur, A. Effects of lignocaine and prednisolone on endoscopic rigid laryngoscopy. Laryngoscope 2006;116:23–7
4Capuzzo, M, Verri, M, Alvisi, R. Hemodynamic responses to laryngoscopy and intubation: etiological or symptomatic prevention? Minerva Anestesiol 2010;76:173–4
5Park, YO, Bang, KS, Choi, EM, Hong, SJ, Kim, IS, Yeong, JY. Plasma lignocaine concentration and hemodynamic effect after 10% lignocaine spray on laryngopharyngeal and intratracheal site during the endotracheal intubation. Korean J Anesthesiol 2005;49:152–6
6Lee, DH, Park, SJ. Effects of 10% lignocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation. Korean J Anesthesiol 2011;60:422–7
7Wenig, BL, Raphael, N, Stern, JR, Shikowitz, MJ, Abramson, AL. Cardiac complications of suspension laryngoscopy. Fact or fiction? Arch Otolaryngol Head Neck Surg 1986;112:860–2
8Pandazi, AK, Louizos, AA, Davilis, DJ, Stivaktakis, JM, Georgiou, LG. Inhalational anesthetic technique in microlaryngeal surgery: a comparison between sevoflurane-remifentanil and sevoflurane-alfentanil anesthesia. Ann Otol Rhinol Laryngol 2003;112:373–8
9Matot, I, Sichel, JY, Yofe, V, Gozal, Y. The effect of clonidine premedication on hemodynamic responses to microlaryngoscopy and rigid bronchoscopy. Anesth Analg 2000;91:828–33
10Hamaya, Y, Dohi, S. Differences in cardiovascular response to airway stimulation at different sites and blockade of the responses by lignocaine. Anesthesiology 2000;93:95103
11Abou-Madi, MN, Keszler, H, Yacoub, JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lignocaine. Can Anaesth Soc J 1977;24:1219
12Mostafa, SM, Murthy, BV, Barrett, PJ, McHugh, P. Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia on the pressor response to direct laryngoscopy and intubation. Eur J Anaesthesiol 1999;16:710
13Sklar, BZ, Lurie, S, Ezri, T, Krichelli, D, Savir, I, Soroker, D. Lignocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation. J Clin Anesth 1992;4:382–5
14Kim, JT, Shim, JK, Kim, SH, Ryu, HG, Yoon, SZ, Jeon, YS et al. Remifentanil vs. lignocaine for attenuating the haemodynamic response during rapid sequence induction using propofol: double-blind randomised clinical trial. Anaesth Intensive Care 2007;35:20–3
15Kyokong, O, Somboonviboon, W. Circulatory responses to endotracheal intubation: the effect of intravenous lidocaine [in Thai]. Thai J Anesthesiol 1986;13:191–4
16Gaumann, DM, Tassonyi, E, Fathi, F, Griessen, M. Effects of topical laryngeal lignocaine on sympathetic response to rigid panendoscopy under general anesthesia. ORL J Otorhinolaryngol Relat Spec 1992;54:4953


Related content

Powered by UNSILO

Effects of lignocaine on pressor response to laryngoscopy and endotracheal intubation during general anaesthesia in rigid suspension laryngoscopy

  • I S Kocamanoglu (a1), S Cengel Kurnaz (a2) and A Tur (a1)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.