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  • Title: Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation.
    Author: Sun HL, Wu TJ, Ng CC, Chien CC, Huang CC, Chie WC.
    Journal: J Clin Anesth; 2009 Mar; 21(2):103-7. PubMed ID: 19329013.
    Abstract:
    STUDY OBJECTIVE: To determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: Operating room of a university hospital. PATIENTS: 56 ASA physical status I and II adult patients scheduled for elective surgery requiring orotracheal intubation and general anesthesia. INTERVENTIONS: 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. MEASUREMENTS: 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. MAIN 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%). CONCLUSION: Oropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.
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