title: Transtracheal lidocaine injection reduces the anesthetic requirements in brachial plexus surgeries.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of transtracheal lidocaine injection to reduce the anesthetic requirements in patients who underwent brachial plexus surgery under general anesthesia.
  
  
  METHODS
  This was a prospective randomized controlled study conducted in 40 consecutive adult patients.
  
  
  METHODS
  The patients were randomly allotted to two groups of 20 patients each. Group A patients received a transtracheal injection of 4 ml of 2% lidocaine before induction of anesthesia and group B patients did not receive it. The two groups were compared in terms of intraoperative propofol requirements and hemodynamic parameters.
  
  
  METHODS
  Statistical analysis was done using Student's t-test for independent samples.
  
  
  RESULTS
  The propofol requirements were significantly less in group A in terms of the number of intraoperative events requiring propofol bolus at various time intervals in 3 h duration (4 vs. 77), the number of patients requiring propofol bolus injections (2 vs. 20), propofol infusion (0 vs. 20), and total propofol requirement (6 vs. 377 mg). After induction, patients in group B showed a statistically significant high heart rate, systolic blood pressure, and mean arterial pressure.
  
  
  CONCLUSIONS
  The present study showed that the group of patients who received transtracheal block with lidocaine had a reduction in the requirement of the induction agent, propofol, and were more stable hemodynamically in the intraoperative period compared to those patients who did not receive transtracheal lidocaine. We conclude that transtracheal injection of lidocaine performed just prior to induction of general anesthesia is an effective alternative to intraoperative propofol infusion when long-acting muscle relaxants are to be avoided.
authors.affiliation: Department of Anaesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Department of Anaesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Nitu
authors.initials: N
authors.lastname: Puthenveettil
authors.affiliation: Department of Head and Neck and Plastic Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Thankappan
authors.affiliation: Department of Anaesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
authors.forename: Jerry
authors.initials: J
authors.lastname: Paul
keywords: Brachial plexus surgeries; lidocaine; transtracheal block