Attenuation of ocular and systemic responses to tracheal intubation by intravenous lignocaine

Area of Science:

• Anesthesiology
• Ophthalmology
• Pharmacology

Background:

• Laryngoscopy and tracheal intubation can cause acute increases in intraocular pressure (IOP).
• Autonomic reflexes triggered by intubation contribute to cardiovascular and ocular pressure changes.
• Preventing IOP spikes is crucial in pediatric patients, especially those with eye injuries.

Purpose of the Study:

• To evaluate the efficacy of intravenous lignocaine in mitigating ocular reactions and IOP increase during laryngoscopy and tracheal intubation.
• To assess the impact of lignocaine on autonomic reflexes in pediatric anesthesia.

Main Methods:

• A randomized controlled trial involving two groups of children undergoing minor eye surgery.
• Experimental group received intravenous lignocaine (2 mg/kg), while the control group received saline.
• Monitoring of ocular reactions, laryngeal reflexes, pulse acceleration, and intraocular pressure.

Main Results:

• Lignocaine significantly reduced the incidence of laryngeal and ocular reflexes.
• Pulse acceleration was significantly lower in the lignocaine group (p < 0.025).
• Maximal mean intraocular pressure was significantly reduced in the lignocaine group (p < 0.005).

Conclusions:

• Intravenous lignocaine effectively suppresses autonomic reflexes, thereby mitigating ocular reactions and acute IOP increases post-intubation.
• Lignocaine is recommended for pediatric patients at risk of elevated IOP, such as those with eye injuries requiring urgent surgery.
• The findings support the use of lignocaine as a prophylactic measure in specific pediatric anesthetic scenarios.