Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation

Ben Zion Sklar, Samuel Lurie*, Tiberiu Ezri, David Krichelli, Irena Savir, David Soroker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Study Objective: To evaluate the effect of lidocaine inhalation on the circulatory response to direct laryngoscopy and endotracheal intubation. Design: Prospective, randomized study. Setting: Operating theater at a public hospital. Patients: Eighty patients (ASA physical status I and II ages 25 to 45 years) scheduled for major abdominal surgery. Interventions: In the first stage, 40 patients were randomly assigned to receive inhalation of either lidocaine 40 mg or a 0.9% solution of sodium chloride (placebo). In the second stage, the next 20 consecutive patients received inhalation of lidocaine 120 mg, and another 20 consecutive patients received intravenous (IV) lidocaine 1 mg/kg. Measurements and Main Results: Mean arterial pressure rose significantly in the IV lidocaine group (21.2 mmHg; p < 0.05), the saline inhalation group (29.2 mmHg; p < 0.05), and the lidocaine 40 mg inhalation group (22.9 mmHg; p < 0.05), but not in the lidocaine 120 mg inhalation group (10.1 mmHg). The heart rate (HR) response to intubation with lidocaine inhalation was dose dependent. In the saline inhalation group, HR increased by 15.6 beats per minute (bpm) (p < 0.05); in the lidocaine 40 mg inhalation group, HR increased by 9.1 bpm (p < 0.05); and in the lidocaine 120 mg inhalation group, HR increased by only 3.1 bpm. Conclusion: Inhalation of lidocaine 120 mg prior to induction of anesthesia is an effective, safe, and convenient method to attenuate the circulatory response to laryngoscopy and endotracheal intubation.

Original languageEnglish
Pages (from-to)382-385
Number of pages4
JournalJournal of Clinical Anesthesia
Volume4
Issue number5
DOIs
StatePublished - 1992
Externally publishedYes

Keywords

  • Anesthesia, inhalation
  • intubation, intratracheal
  • laryngoscopy
  • lidocaine, inhalation of

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