Intravenous Lidocaine as Adjuvant to Sevoflurane Anesthesia for Endotracheal Intubation in Children

Abstract

Supplementing a sevoflurane induction of anesthesia in children with IV lidocaine 2 mg/kg can suppress cough after tracheal intubation and thus improve intubating conditions. In addition, lidocaine minimizes blood pressure fluctuations after tracheal intubation.

Intravenous lidocaine has no impact on rocuronium‐induced neuromuscular block. Randomised study

“…Because there was evidence from previous studies that intubation conditions may be improved in patients receiving intravenous lidocaine, [20][21][22] we evaluated intubation conditions using a published score that takes into account the ease of laryngoscopy (easy, fair, difficult), vocal cords position (abducted, intermediate/moving, closed), and presence of diaphragmatic movement or coughing while inserting the tube (none, slight, vigorous/sustained). 17 The final score summarised intubation conditions as excellent (all qualities are excellent), good (all qualities are either excellent or good), or poor (presence of a single quality listed under 'poor').…”

“…The beneficial effect of intravenous lidocaine on intubation conditions was not unexpected as it has been described before both in adults receiving a neuromuscular blocking agent to facilitate intubation 20 and in children who were intubated without a neuromuscular blocking agent. 22 Also, when inserting a laryngeal mask airway, intravenous lidocaine was reported to decrease the risk of coughing and laryngospasm. 28 We observed fewer diaphragmatic movements and/or coughing on tracheal tube insertion and cuff inflation in patients who were pre-treated with lidocaine.…”

Comparison of Fentanyl and Fentanyl Plus Lidocaine on Attenuation of Hemodynamic Responses to Tracheal Intubation in Controlled Hypertensive Patients Undergoing General Anesthesia

“…Fentanyl is a frequently used opioid that joins with hypnotic agents to diminish hemodynamic responses to tracheal intubation (15-17). Furthermore, lidocaine has a suppressive effect on the circulatory responses in patients undergoing laryngoscopy and tracheal intubation (18, 19). …”

Fentanyl and fentanyl plus lidocaine on attenuation of haemodynamic stress response to laryngoscopy: a comparative study in controlled hypertensive patients posted for laparoscopic cholecystectomy

“…These beneficial effects of lidocaine on hemodynamic stability is possibly due to; direct myocardial depressant effect, peripheral vasodilating effect and the effect on synaptic transmissions. 18,19 Moreover, according to Ali et al in 2010, pre-treatment with lidocaine improves intra-and post-operative hemodynamic stability during laparoscopic surgery without prolonging recovery. 26 Our study was in line with some previous studies such as Shin et al.…”