Document Detail


Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation.
MedLine Citation:
PMID:  19329013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: Operating room of a university hospital. PATIENTS: 56 ASA physical status I and II adult patients scheduled for elective surgery requiring orotracheal intubation and general anesthesia. INTERVENTIONS: 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. MEASUREMENTS: 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. MAIN RESULTS: 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%). CONCLUSION: Oropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.
Authors:
Hsiao-Lun Sun; Tzong-Jeng Wu; Chen-Chuan Ng; Chih-Cheng Chien; Chi-Cheng Huang; Wei-Chu Chie
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  21     ISSN:  1873-4529     ISO Abbreviation:  J Clin Anesth     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adult
Anesthesia, General
Anesthetics, Local* / administration & dosage
Blood Pressure / physiology
Bronchial Spasm / chemically induced,  physiopathology
Double-Blind Method
Electrocardiography
Female
Heart Rate / drug effects
Hemodynamics / physiology*
Humans
Intubation, Intratracheal*
Lidocaine* / administration & dosage
Male
Middle Aged
Oropharynx*
Prospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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