Lidocaine Given Intravenously as a Suppressant of Cough and Laryngospasm in Connection with Extubation After Tonsillectomy

Gefke, Kaj; Andersen, Lars Willy; Friesel, E.; Chalon, Jack

doi:10.1097/00132586-198312000-00047

Cited by 20 publications

(28 citation statements)

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“…Lidocaine applied to the laryngeal mucosa or administered intravenously has been found to decrease the risk of laryngospasm in pediatric patients when administered before extubation 6,7 or prior to intubation 8 . Moreover, the use of a laryngeal mask airway device (LMAD) instead of tracheal intubation may reduce perioperative airway complications.…”

Section: Résumémentioning

confidence: 99%

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Schebesta

Güloglu

Chiari

et al. 2010

Can J Anesth/J Can Anesth

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Purpose To determine the effect of topically applied lidocaine on perioperative airway complications when using a laryngeal mask airway device (LMAD) in children either with or without a history of recent or ongoing upper respiratory tract infection (URI). Methods In a randomized controlled double-blind trial, 34 children with a history of recent or ongoing URI and 32 non-URI children-all of whom were younger than age ten and scheduled to undergo minor surgical procedureswere randomly assigned to either a lidocaine or a placebo group. In the lidocaine group, an LMAD was lubricated with lidocaine gel before insertion, and a clear lubricating gel was used in the placebo group. The following data were recorded after standardized anesthesia induction and airway management: postoperative complications, such as coughing, desaturation, laryngospasm, and increased oral secretions, as well as length of stay in the postanesthetic recovery unit. Results Children with URI had a lower overall perioperative complication rate if they received a lidocaine gel (35%) rather than placebo (94%) (P \ 0.01). Also, the incidence of postoperative coughing was less (12% vs 53%; P = 0.03). In non-URI patients, lidocaine did not significantly reduce the rate of airway complications compared with placebo (17% vs 24%, respectively).Conclusion Lubrication of the LMAD with lidocaine gel reduces the incidence of airway complications in children with an upper respiratory tract infection. RésuméObjectif De´terminer l'effet d'une application topique de lidocaı¨ne sur les complications pe´riope´ratoires au niveau des voies ae´riennes lors de l'utilisation d'un masque larynge( LMAD) chez des enfants avec ou sans infection re´cente ou actuelle des voies respiratoires supe´rieures. Méthode Dans une e´tude randomise´e contrôle´e à double insu, 34 enfants avec une infection re´cente ou actuelle des voies respiratoires supe´rieures et 32 enfants sans infection, tous plus jeunes que 10 ans et devant subir des interventions chirurgicales mineures, ont e´te´randomise´s a`recevoir soit de la lidocaı¨ne, soit un placebo. Dans le groupe lidocaı¨ne, un LMAD a e´te´lubrifie´a`l'aide de lidocaı¨ne en gel avant l'insertion, et un gel lubrifiant clair a e´te´utilise´dans le groupe placebo. Les donne´es suivantes ont e´te´enregistre´es apre`s une induction de l'anesthe´sie et une prise en charge standard des voies ae´riennes: les complications postope´ratoires, telles que toux, de´saturation, laryngospasme et se´cre´tions orales accrues, ainsi que la dure´e de se´jour dans la salle de re´veil post-anesthe´sique. Résultats Les enfants souffrant d'infection des voies respiratoires supe´rieures ont montre´un taux global de complications pe´riope´ratoires plus bas lorsqu'ils ont reçu de la lidocaı¨ne en gel (35 %) plutôt que le placebo (94 %) (P\0,01). De plus, l'incidence de toux postope´ratoire e´tait moindre (12 % vs 53 %; P = 0,03). Chez les patients ne souffrant pas d'infection des voies respiratoires supe´rieures, la lidocaı¨ne n'a pas re´duit le taux de ...

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Section: Résumémentioning

confidence: 99%

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Schebesta

Güloglu

Chiari

et al. 2010

Can J Anesth/J Can Anesth

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“…1~ A reliable technique for improving ETT tolerance while facilitating rapid and full emergence from general anesthesia would be desirable in many situations. "Deep" extubation (removal of the ETT while the patient is still in a deep plane of general anesthesia), administration of intravenous (iv) opioids or iv lidocaine, and local lidocaine spray prior to emergence have been used to diminish coughing.I, [3][4][5][6][7][8][9] Although some authors consider "deep" extubation to be an effective technique to prevent coughing during emergence from general anesthesia, 3,s loss of airway protection and aspiration is a major drawback. Intravenous lidocaine in doses of 1.0-2.0 mg.kg -1, producing a plasma lidocaine level (3 lag.m1-1) can transiently suppress coughing and other airway reflexes.…”

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confidence: 99%

In vitro diffusion of lidocaine across endotracheal tube cuffs

Huang

Tsai

Chen

et al. 1999

Can J Anesth/J Can Anesth

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Purposc: Lidocaine diffuses across endotracheal tube cuffs, which may serve as a reservoir for local anesthetic to assist in the prevention of E-l-l--induced cough while emerging from general anesthesia. However, the rate of diffusion is slow. Two techniques, alkalization and warming, may increase the proportion of uncharged drug available for diffusion. The purpose of this study is to determine the effectiveness of warming alkalization or warming with alkalization on diffusion. Methods: Four preparations of lidocaine 4% were studied. Group (Gr) L -lidocaine (24~ Gr WL -warmed lidocaine (38~ Gr AL -alkalized lidocaine (24~ Gr WAL -warmed, alkalized lidocaine (38~ Twenty-four Mallinckrodt 8.0 ID (Mallinckrodt Critical Care Division of Mallinckrodt, Inc., Glens Falls, New York) endotracheal tube cults were filled with 6 ml of one of the four preparations. They were then placed in a 20 ml water bath at 38~ and samples were drawn from the water bath at intervals for up to 360 rain. The lidocaine concentration in each sample was determined by gas chromatography. Results: The highest lidocaine concentration was reached in Gr WAL (410.98 ---8.53/Jg'ml -i) after 300 min and then decreased to 376.18 ___ 4.59/Jg'ml -~ after 360 rain. In Gr AL the highest concentration (235.05 _-_ 2.99 Hg.ml -I) was reached after 360 rain. Lidocaine concentrations in Gr L and WL after 360 min were 3.19 __-I. 16 Hg-ml -I and 4.32 +-2.02/lg'ml -I respectively. Condition: Alkalization with or without warming, but not warming alone, promotes lidocaine diffusion from endotracheal tube cuff.Obje~df : La lidocaine diffuse, lentement toutefois, au travers des ballonnets des tubes endotrach~aux. Les balIonnets peuvent servir de r&ervoir ~ ranesth&ique local et participer ~ la prevention de la toux induite par le TET pendant la r&up&ation de I'anesth~sie g6n&ale. I'alcalinisation et le r&hauffement peuvent accro~tre la proportion de m~dicament susceptible de diffuser. I'objectif de la pr&ente &ude est de d&erminer I'eflicacit~ du r&hauffement, seul ou avec alcalinisation, sur la diffusion. M&hode : On a &udi~ quatre preparations de lidocaine. Le groupe (Gr) L -lidoca'ine (24 ~ Gr LR -lidoca'ine r&hauff& (38 ~ Gr LA -lidoca/ne alcalinis& (24 ~ Gr LRA -lidocaine r&hauff&, alcalinis& (38 ~ Vingtquatre tubes endotrach6aux ~ ballonnets Mallinckrodt de DI 8,0 (Mallinckrodt Critical Care Division of Mallinckrodt, Inc., Glens Falls, New York) ont fitfi remplis de 6 ml de rune des preparations. Plac& ensuite dans un bain d'eau de 20 ml ~ 38 ~ on en a ensuite retir~ des &hantillons ~ des intervalles pouvant aller jusqu'~ 360 min. La concentration de lidoca'ine a ~t~ d6termin6e par chromatographie en phase gazeuse. R&ultats : La plus forte concentration de lidocaine a ~t~ atteinte dans le Gr LRA, 410,98 ---8,53 Hg'ml-', apr~s 300 rain, puis elle a baiss~ ~ 376, 18 ---4,59 ~/g-ml-' apr& 360 rain. Dans le Gr LA, la concentration maximale &ait de 235,05 ___ 2,99/ag.ml-' apt& 360 rain. Dans les Gr Let LR, la lidoca'l'ne ~tait, apr& 360 rain de 3, 19 _ I, 16/ag.ml-...

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“…At 1 hour post extubation pain was less in the AL group compared to PL group. Throat pain decreased gradually over 24 hours in all three completely by increasing of plasma concentrations of lignocaine in excess of 3 micrograms/ ml [20][21][22][23].…”

Section: Methodsmentioning

confidence: 86%

Prevention of Post Intubation Sore Throat by Using an Alkalinized Lignocaine Filled Ett Cuff

Kumar¹,

Kumar²

2018

IJIMS

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Lidocaine Given Intravenously as a Suppressant of Cough and Laryngospasm in Connection with Extubation After Tonsillectomy

Cited by 20 publications

References 0 publications

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

In vitro diffusion of lidocaine across endotracheal tube cuffs

Prevention of Post Intubation Sore Throat by Using an Alkalinized Lignocaine Filled Ett Cuff

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