Efficacy of sublingual nitroglycerine spray in attenuation of hemodynamics to tracheal extubation

Ameya Arun Tagalpallewar, Bhushan M. Ambare, J. N. Agrawal, Monika S. Masare


Background: The present study was undertaken to evaluate efficacy of nitroglycerine (NTG) spray for attenuating haemodynamic response to tracheal extubation in normotensive and hypertensive patients.

Methods: The study enrolling total 120 ASA I and II patients, (60 normotensive and 60 hypertensive) who had undergone elective surgery under general endotracheal anaesthesia. Both these types of patients were randomly subdivided into two groups of 30 patients each -50% receiving NTG spray and 50% not receiving NTG spray.

Results: There was significant increase in heart rate in all four groups after NTG spray. During extubation this increased in heart rate was not statistically significant in group A (Normotensive with NTG) but was significant in group C (hypertensive with NTG) when compared with control groups. Similarly, during extubation there was significant rise in systolic, diastolic and mean arterial blood pressure were noted in all four groups and with use of NTG spray the increase could be significantly attenuated in NTG groups. Increase in heart rate along with reduction in blood pressure seen after NTG spray did not produce significant increase in RPP as compared to hypertensive and normotensive patients who did not receive the NTG spray.

Conclusions: Sublingually administered nitroglycerin spray in a dose of 0.8 mg prior to extubation is an effective, practical, easy and relatively safe method in attenuate haemodynamic response to tracheal extubation.


Endotracheal anaesthesia, Haemodynamic response, NTG, Tracheal extubation

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