Intratracheal Lidocaine vs Intravenous Lidocaine for Blunting Cordiovascular Response to Endotracheal Intubations
Kovitwanawong N, Kumpubhovichitra P*
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110
Background and objectives : The alteration of hemodynamics caused by endotracheal intubation may cause significant morbidity such as myocardial infarction, myocardial failure or cerebral hemorrhage. Thus, several techniques include deep inhalation, high dose opioid, and antihypertensive drug administering were used to obtund the cardiovascular reflex. However, there were no studies comparing the effects between lidocaine intravenously and intratracheally. There fore , we compare the effects of lidocaine administration prior to intubation either intravenously or intrathacheally on the alteration of hemodynamics. Materials and method : Fifty patients, ASA I-II, scheduled for elective surgery under general anesthesia, were randomized into two groups. Each patient received 1.5 mg/kg of 2% lidocaine either intravenously (IV) or intrathacheally (IT) three minutes after the induction of anesthesia. The mean arterial pressure (MAP) and heart rate were recorded every minute until 5 minutes after intubation and every 5 minutes until the end of the operation. Results : After intubation, the MAP was 104.24 + 20 and 105.24 + 20 mmHg (p = 0.8) and the heart rate was 85.28 + 17 and 86.88 + 17 beats/minute (p = 0.77) in IV and IT group, respectively. The MAP was increased from baseline 12.14% and 12.43% in IV and IT group, respectively (p = 0.96). The increasing in heart rate was 5.53% and 13.98% in IV and IT group, respectively (p = 0.17). Conclusions : Administration of lidocaine prior to intubation either intratracheally or intravenously cause no significant difference in hemodynamic chang. However, administering lidocaine intravenously is considered more convenient and easier than intratracheally because the special equipment is not necessary.
วิสัญญีสาร ปี 2548, January-March ปีที่: 31 ฉบับที่ 1 หน้า 19-25
Lidocaine, hemodynamic change, intratrachea, Intravenous, laryngotracheal anesthesia set