Intravenous lidocaine after tracheal intubation mitigates bronchoconstriction in patients with asthma.
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.
Adamzik
Michael
M
Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Essen, Germany. michael.adamzik@uni-essen.de
Groeben
Harald
H
Farahani
Ramin
R
Lehmann
Nils
N
Peters
Juergen
J
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
D000779:Anesthetics, Local; D008012:Lidocaine