Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation
Journal
Journal of Clinical Anesthesia
Journal Volume
21
Journal Issue
2
Pages
103-107
Date Issued
2009
Author(s)
Abstract
To determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation. Prospective, randomized, double-blind, placebo-controlled study. Operating room of a university hospital. 56 ASA physical status I and II adult patients scheduled for elective surgery requiring orotracheal intubation and general anesthesia. Patients were randomized to receive oropharyngeal instillation with either 5 mL 2% lidocaine (n = 28, lidocaine group) or 5 mL normal saline (n = 28, control group) 45 seconds after anesthetic induction bolus. Orotracheal intubation was attempted three minutes later. Systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at baseline, just before intubation, and for three minutes postintubation at one-minute intervals. Occurrence of adverse events such as arrhythmias, ischemic changes in electrocardiography, and bronchospasm after intubation were also documented. All postintubation values of SBP, DBP, MAP, and HR were significantly lower in the lidocaine group than the control group (P < 0.01). In both groups, postintubation HRs were significantly higher than baseline values (P < 0.05). More patients (P < 0.001) became hypertensive postintubation in the control group (14/28, 50%) than the lidocaine group (2/28, 7%). Oropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.
SDGs
Type
journal article