Efficacy of intranasal versus intravenous nitroglycerine in laparoscopic cholecystectomy - A Randomized controlled trial.

Nitroglycerine is an organic nitrate which is a venous as well as arterial dilator which releases nitric oxide and causes relaxation of vascular smooth muscles. Dilation of larger veins promotes peripheral pooling of blood which in turn reduces preload. At higher doses, it leads to arterial relaxation which reduces systemic vascular resistance and hence, the afterload.

There are few studies available in the literature regarding the use of intranasal nitroglycerine and intravenous nitroglycerine for attenuation of pressure response. Intranasal nitroglycerine as an alternative to conventional intravenous route has recently been shown to have positive perioperative outcomes in multiple studies. The preferable route of nitroglycerine administration to achieve this without causing much side effects is not yet clear. Hence, this study is designed to find out preferable route of nitroglycerine administration for reducing the hypertensive response to pneumoperitoneum.