title: Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation.
abstract: OBJECTIVE
  To determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation.
  
  
  METHODS
  Prospective, randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Operating room of a university hospital.
  
  
  METHODS
  56 ASA physical status I and II adult patients scheduled for elective surgery requiring orotracheal intubation and general anesthesia.
  
  
  METHODS
  Patients 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.
  
  
  METHODS
  Systolic (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.
  
  
  RESULTS
  All 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%).
  
  
  CONCLUSIONS
  Oropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.
authors.affiliation: Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Hsiao-Lun
authors.initials: HL
authors.lastname: Sun
authors.forename: Tzong-Jeng
authors.initials: TJ
authors.lastname: Wu
authors.forename: Chen-Chuan
authors.initials: CC
authors.lastname: Ng
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Chien
authors.forename: Chi-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Wei-Chu
authors.initials: WC
authors.lastname: Chie