Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation.
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.
Sun
Hsiao-Lun
HL
Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
Wu
Tzong-Jeng
TJ
Ng
Chen-Chuan
CC
Chien
Chih-Cheng
CC
Huang
Chi-Cheng
CC
Chie
Wei-Chu
WC