Propofol versus lidocaine on prevention of laryngospasm in tonsillectomy: A randomized clinical trial

Abstract

Laryngospasm is an important complication of tonsillectomies. This study aimed to compare the effects of propofol versus lidocaine on prevention of laryngospasm in tonsillectomy. This randomized clinical trial included 102 patients who met the inclusion criteria. Patients were randomly divided into two groups treated with 0.5 mg/kg propofol (group P) or 1 mg/kg lidocaine 2% (group L). The frequencies of laryngospasm (within 10 min after extubation), agitation, nausea, vomiting, mean heart rate and mean arterial pressure (MAP) were assessed in both groups. Data were analyzed using SPSS software version 16 at a 95% confidence level. There were no significant differences between the two groups in terms of sex, age or weight. In the P group, the frequency of laryngospasm was significantly lower than L within10 minutes after extubation (4.1% versus 16.3%). Furthermore, the frequencies of agitation (p = 0.003), nausea and vomiting (p = 0.002) and mean heart rate (p = 0.026) were significantly higher in the L group than the P group. However, there were no differences between the two groups in terms of mean systolic and diastolic blood pressure, MAP, SPO2, awakening time, length of stay in recovery and frequency of shivering. Propofol can reduce the incidence of laryngospasm, agitation, nausea and vomiting but it has no effect on the patient's awakening time and length of stay in recovery.

Post adenotonsillectomy coughing and laryngospasm in children: preextubation mini-dose suxamethonium, lidocaine, and their combination prove prophylactic

“…17 Again, relative to the observation by Sanikop et al of 5.4% incidence in laryngospasm in their 1.5 mg/kg lidocaine group, the reported higher incidence of 16.3% by Manouchehrian et al in the group that received intravenous 1 mg/kg lidocaine 2% indicated likely association between an intravenous lidocaine dose <1.5 mg/kg and a suboptimal prophylactic efficacy against laryngospasm post paediatric adenotonsillectomy. 11,18 According to earlier scientific reports, the efficacy of intravenous lidocaine is time dependent. Erb et al noted that, compared to the findings of their assessment at 10 minutes, the group of children assessed at 2 minutes after intravenous 2 mg/kg lidocaine recorded a significantly lower incidence of laryngospasm, indicating a short lived drug effect.…”

Comparison of intravenous injection of magnesium sulfate and lidocaine effectiveness on the prevention of laryngospasm and analgesic requirement in tonsillectomy

“… 26 Although these complications are often short-term, they may need a drug intervention, long-term recovery hospitalization, parent's concerns, damage to catheters and dressings, and disconnection of monitoring cables. 27 , 28 In the study of Manouchehrian et al (2022) 29 102 children aged 3 to 14 years who were candidates for tonsillectomy were studied in two groups. Patients in the lidocaine group received 1 mg / kg lidocaine and in the propofol group received 0.5 mg / kg propofol intravenously two minutes before extubation.…”