Comparison of Ropivacaine with Lignocaine by Nebulization for hemodynamic stress response during Extubation in patients undergoing surgeries under General Anaesthesia

Hemodynamic changes such as increase in Blood Pressure, Heart Rate during airway management is common and can be associated with severe cardiovascular and neurological complications in some patients. Intravenous Lignocaine is commonly used to attenuate this response. Nebulization with local anaesthetics is also an alternative.

The techniques to suppress hemodynamic stress response include topical anaesthesia of oropharynx (viscous lignocaine) laryngotracheal instillation of lignocaine just prior to intubation, intravenous lignocaine, adrenergic blocking drugs (either alpha or beta blockers), vasodilators like hydrallazine, sodium nitroprusside, nitroglycerine, deep inhalational anaesthesia, intravenous opioids etc. However, no single agent has been established as the most appropriate for this purpose

In present study, we propose to evaluate and compare two local anaesthetic nebulization that is Lignocaine (2%) and Ropivacaine (0.75%) for their effect on extubation stress response. We hypothesized that Ropivacaine being longer acting should be able to suppress the extubation response better than Lignocaine.