Canadian Anaesthetists’ Society Journal

, Volume 31, Issue 5, pp 497–502 | Cite as

A comparison of pre treatment regimens for minimizing the haemodynamic response to blind nasotracheal intubation

  • Michele L. Hartigan
  • Jeanette L. Cleary
  • Jeffrey B. Gross
  • David W. Schaffer
Reports of Investigation


The authors determined the cardiovascular effects of blind nasotracheal intubation in four randomized groups of 25 patients each, After induction of anaesthesia with IV thiopentone 4 mg-kg-1, patients in group A received no pretreatment, while patients in group B received IV iidocaine 1.5 mg-kg-1. Three minutes before induction, patients in group C received 0 25 per cent phenylephrine nasal spray (0.2 mg in each nostril); those in group D received ten per cent Iidocaine nasal spray (30 mg in each nostril). After intubation, mean arterial pressures (MAP) were highest in group B (IV Iidocaine) patients (p < 0.05), remaining significantly elevated for 5 min. Conversely, within four minutes after intubation, MAP of group D (ten per cent nasal Iidocaine spray) patients were below control (p < 0.05), and lower than those of any other group (p < 0.05). MAP of group A and C patients increased after intubation, but not as much as in group B patients (p < 0.05). There were no adverse effects from the lidocaine nasal spray. Ten per cent lidocaine nasal spray is a safe and effective way to minimize the MAP increases which typically accompany blind nasotracheal intubation in lightly anaesthetized patients.

Key words

Anaesthetics Local: lidocaine Intubation: nasotracheal Sympathetic nervous system: sympathomimetic agents phenylephrine 


Ce travail a porté sur I’observation des ejfets cardiovas-culairesde I’intubation naso-trachéle à I’aveugle chez 100 maiades distribués au hasard également dans quatre groupes différents. Après I’induction de I’anesthésie au thiopental intrave’meux (4 mg-kg-1), ies patients du groupe A ne recurent aucune médication, ceux du groupe requrent de la lidoca’i’ne intraveineuse a 1.5 mg-kg-’. Trois minutes avant ’induction Ies patients du groupe C requrent de la phenylephrine 0.25 pour cent en vaporisation nasale (0.2 mg dans chaque narine). Les maiades du groupe D requrent de la lidoca’i’ne dix pour vent en vaporisation nasale (30 mg dans chaque narine), Apres !’intubation les pressions arterielles moyennes (MAP) etaieni plus elevees chez les patients du groupe B (lidoca’i’ne IV) (p < 0,05). Les pressions se sont maintenues elevees pendant cinq minutes.

Inversement, mains de quatre minutes apres i intubation, les pressions arterielles des patients du groupe D (lidocai’ne dix pour cent par voie nasale) etaient en bas des valeurs de controle (p < 0.05) et plus basses que les pressions trouvees dans les autres groupes (p < 0.05). Les pressions arterielles moyennes des patients des groupes A et C ont augmente apres V intubation rnais mains que chez les patients du groupe B (p < 0,05). On n’a observe aucun effet indesirable de la vaporisation nasale de licocame. La lidocai’ne a dix pour cent en vaporisation nasale represente done un moyen sur et efficace de diminuer la riponse hypertensive qui accompagne régulièrement I ’intubation naso-trachéale chez les patients sous anesthésie légère.


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Copyright information

© Canadian Anesthesiologists 1984

Authors and Affiliations

  • Michele L. Hartigan
    • 1
  • Jeanette L. Cleary
    • 1
  • Jeffrey B. Gross
    • 1
  • David W. Schaffer
    • 1
  1. 1.Departments of Anesthesia, Nazareth HospitalUniversity of Pennsylvania, and Philadelphia Veterans Administration Medical CenterPhiladelphiaUSA

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