title: Intravenous lidocaine after tracheal intubation mitigates bronchoconstriction in patients with asthma.
abstract: BACKGROUND
  Although prophylactic IV administration of lidocaine attenuates the response to a variety of inhalation challenges, its effect on airway resistance after endotracheal intubation in patients with asthma is unclear. We tested the hypothesis that IV lidocaine attenuates intubation-evoked bronchoconstriction in patients with asthma.
  
  
  METHODS
  Thirty patients with asthma (age 49.1 +/- 15.6 yr [mean +/- sd]) undergoing intubation after standardized anesthetic induction (etomidate 0.3 mg/kg, fentanyl 5 microg/kg, rocuronium 0.6 mg/kg, 50% nitrous oxide) were studied. Airway resistance was measured immediately after intubation and 5, 10, and 15 min later. Five minutes after intubation, either lidocaine (2 mg/kg IV for 5 min, followed by 3 mg x kg(-1) x h(-1) for 10 min) or saline was administered.
  
  
  RESULTS
  Airway resistance immediately after intubation averaged 23 +/- 12 cm H2O x s x L(-1). Airway resistance further increased (+38%) after administration of saline, but decreased (-26%, P < 0.004) to less than the initial values after lidocaine.
  
  
  CONCLUSIONS
  IV lidocaine given after endotracheal intubation mitigates bronchoconstriction in patients with asthma.
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Essen, Germany. michael.adamzik@uni-essen.de
authors.forename: Michael
authors.initials: M
authors.lastname: Adamzik
authors.forename: Harald
authors.initials: H
authors.lastname: Groeben
authors.forename: Ramin
authors.initials: R
authors.lastname: Farahani
authors.forename: Nils
authors.initials: N
authors.lastname: Lehmann
authors.forename: Juergen
authors.initials: J
authors.lastname: Peters
mesh_terms: D000328:Adult; D000368:Aged; D000403:Airway Resistance / Q000187:drug effects / Q000502:physiology*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001249:Asthma / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects; D016084:Bronchoconstriction / Q000187:drug effects / Q000502:physiology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D013147:Spirometry
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine