Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation

Abstract

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

Effects of Intravenous Lidocaine on QTd and HRV Changes Due to Tracheal Intubation During Sevoflurane Induction

“…Heart rate variability analysis has also been used to assess the autonomic effects of pharmacological agents, including beta-blockers, calcium blockers, antiarrhythmics, psychotrophic agents, and cardiac glycosides. 15,16) Owing to the fact that The different results obtained in studies using simple parameters are difficult to compare because of variations in the route of lidocaine administration, 7,19) speed of injection, dose, interval between administration and TI, 6,20) duration of TI, patient population, premedication, 21) additional use of opioids, 6) method of data collection, and statistical analysis.…”

“…Topical or intravenous (IV) lidocaine, an amide local anaesthetic, is one of the agents frequently administered before anaesthesia induction in the above-mentioned situations, even though the effects of lidocaine on these reactions during TI are still controversial. 6,7) Several studies have examined the efficiency of IV lidocaine for attenuation of the cardiovascular responses to TI. However, the results of these studies have been inconsistent.…”

L’intubation endotrachéale avec stylet lumineux ou laryngoscope produit des variations hémodynamiques comparables chez des malades atteints de cardiopathie ischémique

“…[14][15][16] The use of 5 µg·kg -1 of fentanyl together with inhalational anesthesia can blunt the cardiovascular responses to intubation. 17,18 In spite of similar maneuvers in both groups we obtained a significant and similar increase in MAP and HR with both techniques, reinforcing our belief that direct laryngoscopy and lightwand intubation behave similarly in this clinical setting.…”

Comprendre les réactions hémodynamiques à l’intubation endotrachéale

“…8 Although topical lidocaine has been found to be ineffective in the past, 9 Takita et al took the appropriate approach of waiting for the onset of effect (two minutes) to allow topical anesthesia to take place before performing tracheal intubation. Cardiovascular responses in this group of patients were significantly less than that of the group with no tracheal lidocaine, as well as the group with tracheal intubation immediately following tracheal lidocaine.…”

“…8 Bien que, dans le passé, on ait découvert que l'administration topique de lidocaïne était inefficace 9 , Takita et coll. ont adopté la démarche qui convenait en attendant le début de l'effet (deux minutes) pour permettre à l'anesthésie topique d'agir avant de réaliser l'intubation.…”