Comparison of the effects of topical Lidocaine spray applied oropharyngealy before and hypopharyngealy after induction of anesthesia on the pressor response to direct laryngoscopy and intubation

Background & Objective: The deterious effects of pressor response (Tachycardia and hypertension) are not hidden from any personal of anesthesia group. The present study is performed in Chamran Hospital affiliated to the university of medical sciences, Shiraz, with the aim to introduce the most effective, cheapest as well as the easiest method to prevent or reduce the pressor response to direct laryngoscopy and intubation. Materials & Methods: This randomized clinical trial was conducted in Chamran Hospital in Shiraz. 90 patients scheduled for elective surgical fixation of femur or tibia were randomly divided in group A (30 patients), group B (30 patients) and group C (30 patients). In-group A patients were directly sprayed with Lidocaine 10%, hypopharyngealy, after induction of anesthesia and 3 minutes before tracheal intubation. Patients in group B were sprayed with Lidocaine 10% oropharyngealy before induction of anesthesia while the patients, were awake, patients in group C were not sprayed with Lidocaine (Control group). Premedication and drugs used for induction of anesthesia were same in 3 groups. The heart rate, systolic and diastolic blood pressure were recorded in all patients included in the study, before tracheal intubation (Base line) just after tracheal intubation and 3 and 5 minutes after intubation. Results: Spraying Lidocaine oropharyngealy before induction of anesthesia and hypopharyngealy after induction of anesthesia both were effective in controlling the pressor response to laryngoscopy and tracheal intubation, but spraying Lidocaine oropharyngealy before induction of anesthesia is more effective than spraying Lidocaine hypopharyngealy after induction of anesthesia (P