• Hsiao-Lun Sun, Tzong-Jeng Wu, Chen-Chuan Ng, Chih-Cheng Chien, Chi-Cheng Huang, and Wei-Chu Chie.
• Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
• J Clin Anesth. 2009 Mar 1;21(2):103-7.

Study ObjectiveTo determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation.DesignProspective, randomized, double-blind, placebo-controlled study.SettingOperating room of a university hospital.Patients56 ASA physical status I and II adult patients scheduled for elective surgery requiring orotracheal intubation and general anesthesia.InterventionsPatients 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.MeasurementsSystolic (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 ResultsAll 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%).ConclusionOropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.

30 keywords...

hide…