The effect of lidocaine on neutrophil respiratory burst during induction of general anaesthesia and tracheal intubation.
OBJECTIVE
Respiratory burst is an essential component of the neutrophil's biocidal function. In vitro, sodium thiopental, isoflurane and lidocaine each inhibit neutrophil respiratory burst. The objectives of this study were (a) to determine the effect of a standard clinical induction/tracheal intubation sequence on neutrophil respiratory burst and (b) to determine the effect of intravenous lidocaine administration during induction of anaesthesia on neutrophil respiratory burst.


METHODS
Twenty ASA I and II patients, aged 18-60 years, undergoing elective surgery were studied. After induction of anaesthesia [fentanyl (2 microg kg-1), thiopental (4-6 mg kg-1), isoflurane (end-tidal concentration 0.5-1.5%) in nitrous oxide (66%) and oxygen], patients randomly received either lidocaine 1.5 mg kg-1 (group L) or 0.9% saline (group S) prior to tracheal intubation. Neutrophil respiratory burst was measured immediately prior to induction of anaesthesia, immediately before and 1 and 5 min after lidocaine/saline.


RESULTS
Neutrophil respiratory burst decreased significantly after induction of anaesthesia in both groups [87.4 +/- 8.2% (group L) and 88.5 +/- 13.4% (group S) of preinduction level (P < 0.01 both groups)]. After intravenous lidocaine (but not saline) administration, neutrophil respiratory burst returned towards preinduction levels, both before (97.1 +/- 23.6%) and after (94.4 +/- 16.6%) tracheal intubation.


CONCLUSIONS
Induction of anaesthesia and tracheal intubation using thiopentone and isoflurane, inhibit neutrophil respiratory burst. This effect may be diminished by the administration of lidocaine.
Swanton
B J
BJ
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Cork, Ireland.
Iohom
G
G
Wang
J H
JH
Redmond
H P
HP
Shorten
G D
GD
D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000009:adverse effects; D008012:Lidocaine / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects* / Q000378:metabolism; D011446:Prospective Studies; D016897:Respiratory Burst / Q000187:drug effects*; D013874:Thiopental / Q000009:adverse effects
D000779:Anesthetics, Local; D008012:Lidocaine; D007530:Isoflurane; D013874:Thiopental; D005283:Fentanyl