Materials and Methods: A total of 100 patients who fulfilled the inclusion criteria and  consented were included in the randomized double blinded trial and divided into two groups;  Group 1 received lignocaine combined with adrenaline nebulization and Group 2 received  standard nebulized bronchodilators. The treatment response was monitored. Patient’s  respiratory secretion was assessed by number of suctions for tracheal toileting per 8 hours and  cough severity was assessed by Cough symptom score (CSS). additionaly day to weaning from  ventilator was documented.  

Data Collection: Data will be collected at baseline and regularly throughout the study  period by google forms filled by care taking staff and investigators team of doctors Respiratory  parameters were assessed 8th hourly followed by regular assessments and emergency  intervention as and when needed were done.

Statistical Analysis: We applied independent sample t-test. p-value less than 0.05, so there  is a significant difference in average cough [p value of 0.0001], average secretion toileting  frequency [p value of 0.0001] between loxicard and control groups. Mean of control group is  always more as compare to loxicard group for average cough, average secretion and ventilator  weaned days [p value of 0.0001]. Though expected, there was no gender variation among the  study or control group and with a p-value of 0.27 hence statistical significance of variation  among men and women were nill.

 Ethical Considerations: Informed consent was obtained from all participants or their legally  authorized representatives. Any deterioration warranting a shift from the current medications  were duly undertaken and no patient was released from the study group due to unforeseen  complications

Objective: To investigate the effectiveness of Lignocaine in combination with adrenaline   nebulization as a therapeutic intervention  in the treatment of tracheostomized  head injury patients over standard  bronchodilator therapy, thereby  demonstrating better upper respiratory  symptom mitigation.  

Conclusion: This study aims to contribute  valuable insights into the potential benefits  of Loxicard combined with adrenaline  nebulization in tracheostomized head   injury patients. Trying other combinations such as ropivacaine with or without adrenaline  can be tested in the future. The findings may guide future clinical practice and research in  optimizing respiratory and neurological outcomes in this specific patient population.