After shifting the patient inside the operative room, standard ASA monitors will be attached and baseline parameters of heart rate (HR), noninvasive blood pressure (NIBP), continuous electrocardiogram (ECG) and arterial oxygen saturation (SpO2) will be noted. An intravenous line secured with an 18 G cannula, and all patients will be received ringer lactate infusion at a rate of 10 ml/kg/hr.  As per the institutional protocol general anaesthesia induction will be proceeded. All patients will be premedicated with injection IV glycopyrrolate 0.005mg/kg mg and midazolam 0.05 mg/kg Anesthesia will be induced in the supine position with the head on a standard pillow of 7 cm in height. After preoxygenation for three minutes, anesthesia will be induced using propofol 2mg/kg. After checking for the ability to achieve adequate mask ventilation, succinylcholine 2mg/kg will be used to facilitate muscle relaxation.

Study procedure in Group A:

When the muscles are completely relaxed, by using a laryngo-tracheal mucosal atomization device 2 mL of study drug (0.75% ropivacaine) instilled intratracheally to allow uniform surface anesthesia. After study drug instillation, the patient will be intubated using endotracheal tube 7.0–7.5 mm ID for female patients and 7.5–8.5 mm ID for male patients. Intubation will be performed by direct laryngoscopy. After ensuring the proper position of the endotracheal tube, the cuff will be inflated with air.

 Study procedure in Group C:  

After achieving complete muscle relaxation, using direct laryngoscopy, patient will be intubated using endotracheal tube of 7.0-7.5 mm ID for female patients and 7.5-8.5mm ID for male patients. After ensuring the proper position of the endotracheal tube, the cuff will be inflated with 3ml of study drug (0.75% ropivacaine).