To study the effect of lignocaine nebulization on attenuation of the pressor response during induction and emergence of anesthesia in patients with severe pre-eclampsia

The pressor response to laryngoscopy and tracheal intubation is a very important issue in hypertensive pregnant patients that can lead to increased maternal intracranial pressure, cerebral haemorrhage, and cardiac failure with pulmonary oedema and may result in maternal mortality. The catecholamine release associated with laryngoscopy and intubation also causes uteroplacental vasoconstriction and adversely affect the neonate well-being.

Therefore, the precise control of stress is necessary during general anesthesia in pre-eclamptic patients.Various drugs are used to suppress the pressor response including opioids, lidocaine, along with α and β adrenergic blockers.

in this study the investigators will evaluate the effect of lignocaine nebulization on attenuation of the pressor response.

Inclusion Criteria:

• American Society of Anesthesiologist (ASA) II , III with severe pre-eclampsia
• Scheduled for caesarean deliveries under general anesthesia

Exclusion Criteria:

• severe obesity (BMI ≥ 40 )
• Cardiac patients
• History of diabetes
• Renal dysfunction (Elevated creatinine ≥ 2 mg\dl)
• Hepatic dysfunction (Elevated hepatic enzymes three times above normal value)
• Known fetal anomalies