Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation.
OBJECTIVE
To evaluate the effect of lidocaine inhalation on the circulatory response to direct laryngoscopy and endotracheal intubation.


METHODS
Prospective, randomized study.


METHODS
Operating theater at a public hospital.


METHODS
Eighty patients (ASA physical status I and II ages 25 to 45 years) scheduled for major abdominal surgery.


METHODS
In the first stage, 40 patients were randomly assigned to receive inhalation of either lidocaine 40 mg or a 0.9% solution of sodium chloride (placebo). In the second stage, the next 20 consecutive patients received inhalation of lidocaine 120 mg, and another 20 consecutive patients received intravenous (IV) lidocaine 1 mg/kg.


RESULTS
Mean arterial pressure rose significantly in the i.v. lidocaine group (21.2 mmHg; p < 0.05), the saline inhalation group (29.2 mmHg; p < 0.05), and the lidocaine 40 mg inhalation group (22.9 mmHg; p < 0.05), but not in the lidocaine 120 mg inhalation group (10.1 mmHg). The heart rate (HR) response to intubation with lidocaine inhalation was dose dependent. In the saline inhalation group, HR increased by 15.6 beats per minute (bpm) (p < 0.05); in the lidocaine 40 mg inhalation group, HR increased by 9.1 bpm (p < 0.05); and in the lidocaine 120 mg inhalation group, HR increased by only 3.1 bpm.


CONCLUSIONS
Inhalation of lidocaine 120 mg prior to induction of anesthesia is an effective, safe, and convenient method to attenuate the circulatory response to laryngoscopy and endotracheal intubation.
Sklar
B Z
BZ
Department of Anesthesia, Kaplan Hospital, Rehovot, Israel.
Lurie
S
S
Ezri
T
T
Krichelli
D
D
Savir
I
I
Soroker
D
D
D000328:Adult; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies
D010919:Placebos; D008012:Lidocaine