Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia on the pressor response to direct laryngoscopy and intubation

Barrett, P.J.; McHugh, Paul E.

doi:10.1046/j.1365-2346.1999.00410.x

Cited by 19 publications

(15 citation statements)

References 7 publications

(7 reference statements)

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“…The efficacy of tracheal lidocaine for attenuation of the cardiovascular responses to tracheal intubation has not been fully established and some authors have questioned its efficacy. [8][9][10] It is unknown whether the magnitude of the cardiovascular responses to tracheal lidocaine alone is less than that of endotracheal intubation without topical anesthesia. If the magnitude of the cardiovascular responses to tracheal lidocaine alone is as great as that produced by endotracheal intubation, it would have limited usefulness as an attenuating drug.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] In the study of Denlinger et al, 11 endotracheal intubation was performed more than two minutes after a tracheal spray with local anesthetics while endotracheal intubation was performed less than one minute after topical anesthesia in the studies that indicated the ineffectiveness of tracheal lidocaine. [8][9][10] Our study suggests that differing intervals between tracheal lidocaine and endotracheal intubation probably caused the inconsistent conclusions reported in other investigations. Our results show that endotracheal intubation performed two minutes after tracheal lidocaine attenuates the cardiovascular responses to endotracheal intubation.…”

Section: Me Et Th Ho Od Ds Smentioning

confidence: 99%

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Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation

Takita

Morimoto

Kemmotsu

2001

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : In order to examine the efficacy of tracheal lidocaine (TL) for attenuation of the cardiovascular responses to endotracheal intubation (EI), we compared the cardiovascular responses to TL alone and EI with TL, with those to EI without TL.M Me et th ho od ds s: : Seventy-five patients (ASA I-II) were studied. Anesthesia was induced with fentanyl 2 µg·kg 1 iv, thiamylal 5 mg·kg 1 iv and sevoflurane 1.0% in oxygen. Vecuronium 0.12 mg·kg 1 was used to facilitate EI. In Group A (n=25), three minutes after induction, EI was performed. In Group B (n=25), three minutes after induction, the patients received TL (4% lidocaine, 4 mL). This was followed by immediate EI. In Group C (n=25), EI was performed two minutes after TL. Heart rate, arterial blood pressure and rate-pressure product (RPP) were measured from one minute before induction until five minutes after EI.R Re es su ul lt ts s: : The changes of RPP caused by TL alone in Group C (TL; +34.6 ± 29.0%, mean ± SD) were significantly (P <0

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Section: Discussionmentioning

confidence: 99%

Section: Me Et Th Ho Od Ds Smentioning

confidence: 99%

Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation

Takita

Morimoto

Kemmotsu

2001

Can J Anesth/J Can Anesth

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“…Although there may be systemic absorption of topical lidocaine administered as an oropharyngeal spray, Mostafa et al 22 found that the plasma lidocaine concentrations after topical lidocaine 3 mgÁkg -1 (0.8 ± 0.41 lgÁmL -1 ) were well below the toxic range (5-9 lgÁmL -1 ). We chose to use an even lower dose of topical lidocaine (40 mg) because this dose has been found to be effective in improving LMA insertion conditions.…”

mentioning

confidence: 99%

Topical lidocaine improves conditions for laryngeal mask airway insertion

Changchien¹,

Chen²,

Hsieh³

et al. 2010

Can J Anesth/J Can Anesth

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Purpose We hypothesized that optimal laryngeal mask airway (LMA TM ) insertion conditions might be achieved with topical lidocaine and a smaller dose of propofol. In this study, insertion conditions after topical lidocaine 40 mg followed by propofol 2 mgÁkg -1 were compared with propofol 2 mgÁkg -1 or propofol 3 mgÁkg -1 alone. Methods Ninety patients were recruited for this randomized prospective double-blind study. One group received four sprays of topical lidocaine (40 mg) over the posterior pharyngeal wall followed by propofol 2 mgÁkg -1 (Group 2PL; n = 30). The other two groups received four sprays of 0.9% normal saline followed by propofol 2 mgÁkg -1 (Group 2P; n = 30) or by propofol 3 mgÁkg -1(Group 3P; n = 30). The frequency of optimal insertion conditions (successful insertion at the first attempt without adverse responses) and side effects were recorded. Results The frequency of optimal insertion conditions was greater in Group 2PL (20/30, 67%) and Group 3P (22/ 30, 73%) than in Group 2P (11/20, 37%) (P = 0.009). In Group 3P, the mean blood pressure was lower than in the other groups prior to LMA-Classic TM insertion (P = 0.003) but was similar after insertion. The incidence of apnea was greater in Group 3P patients (17/30, 57%) than in Group 2P (2/30, 7%) or Group 2PL patients (1/30, 3%) (P \ 0.001). Conclusion Topical lidocaine 40 mg followed by propofol 2 mgÁkg -1 can provide optimal insertion conditions of the LMA-Classic comparable to those of propofol 3 mgÁkg -1 , with fewer hemodynamic changes and a lower incidence of apnea. RésuméObjectif Nous avons e´mis l'hypothe`se que des conditions optimales d'insertion du masque larynge( LMA TM ) pourraient eˆtre cre´e´es graˆce a`l'utilisation de lidocaı¨ne topique et une dose moindre de propofol. Dans cette e´tude, nous avons compare´les conditions d'insertion apre`s 40 mg de lidocaı¨ne topique puis 2 mgÁkg -1 de propofol, avec 2 mgÁkg -1 de propofol ou 3 mgÁkg -1 de propofol sans lidocaı¨ne topique. Méthode Quatre-vingt-dix patients ont e´te´recrute´s dans cette e´tude prospective randomise´e à double insu. Un groupe a reçu quatre pulve´risations de lidocaı¨ne topique (40 mg) sur la paroi pharynge´e poste´rieure, puis 2 mgÁkg -1 de propofol (groupe 2PL; n = 30). Les deux autres groupes ont reçu quatre pulve´risations de se´rum physiologique a`0,9 %, puis 2 mgÁkg -1 de propofol (groupe 2P; n = 30) ou 3 mgÁkg -1 de propofol (groupe 3P; n = 30). La fre´quence de conditions d'insertion optimales (insertion re´ussie a`la premie`re tentative sans re´action ne´gative) et les effets secondaires ont e´te´enregistre´s. Résultats La fre´quence de conditions d'insertion optimales e´tait plus e´leve´e dans le groupe 2PL (20/30, 67 %) et le groupe 3P (22/30, 73 %) que dans le groupe 2P (11/30, 37 %) (P = 0,009). Dans le groupe 3P, la tension

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“…Several studies have examined the efficacy of tracheal lidocaine in attenuating the hemodynamic responses to endotracheal intubation [9,19,20], with inconsistent results, depending on the timing of lidocaine administration. Tracheal administration of lidocaine 1 min before tracheal intubation was ineffective for attenuation of the cardiovascular response to intubation [19,20].…”

Section: Discussionmentioning

confidence: 99%

Effect of tracheal lidocaine on intubating conditions during propofol-remifentanil target-controlled infusion without neuromuscular blockade in day-case anesthesia

Kim

Joe

et al. 2013

Korean J Anesthesiol

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BackgroundLidocaine is a useful intravenous and topical adjunct to facilitate tracheal intubation. We evaluated the effect of tracheal lidocaine on tracheal intubating conditions without neuromuscular blocking agent and hemodynamics during anesthesia induction with propofol and remifentanil target-controlled infusion (TCI).MethodsFifty patients, aged 18-60 years, scheduled for closed reduction of fractured nasal bone were randomly assigned to the control group (n = 25) or lidocaine group (n = 25). Anesthesia was induced with propofol-remifentanil TCI with the effect-site concentration of 5 µg/ml and 5 ng/ml. Four minutes after the start of propofol-remifentanil TCI, 4% lidocaine or saline 3 ml was instilled to larynx and trachea, and intubation was performed 1 min later. Acceptable intubation was defined as excellent or good intubating conditions. Hemodynamic data, induction and recovery profiles were recorded.ResultsIntubating condition was clinically acceptable in 13 out of 25 (52%) patients in the control group and in 22 out of 25 (88%) in the lidocaine group, and there was a significant difference between the two groups in regard to acceptable intubating conditions (P = 0.005). Mean arterial pressure change over time was significantly different between the two groups. There were no significant differences in the heart rate between the two groups.ConclusionsThis study demonstrated that laryngotracheal administration of 4% lidocaine could increase the percentage of acceptable conditions for tracheal intubation during propofol and remifentanil anesthesia without neuromuscular blockade.

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Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia on the pressor response to direct laryngoscopy and intubation

Cited by 19 publications

References 7 publications

Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation

Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation

Topical lidocaine improves conditions for laryngeal mask airway insertion

Effect of tracheal lidocaine on intubating conditions during propofol-remifentanil target-controlled infusion without neuromuscular blockade in day-case anesthesia

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