Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation

Lee, Deok Hee; Park, Sang Jin

Abstract

BACKGROUND
It is well known that suspension laryngoscopy (SL) produces marked hemodynamic changes. Coughing during extubation sometimes causes adverse clinical problems. We investigated whether 10% lidocaine spray could attenuate hemodynamic stress responses due to SL and reduce coughing incidence during extubation.
METHODS
Sixty patients undergoing SL were randomly divided into two groups and intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine, sprayed onto laryngeal and intratracheal sites 2 min prior to intubation (10% lidocaine group). Mean arterial pressure (MAP) and heart rates (HR) during SL and coughing incidence during extubation were recorded.
RESULTS
MAP at 2.5 and 5 min (P < 0.05) and HR at 2.5 min after SL (P < 0.01) were greater in the control group than in the 10% lidocaine group. The number of coughs decreased in the 10% lidocaine group compared to the control group during pre- (6.8 +/- 3.2 vs 10.3 +/- 4.4, P < 0.01) and post-extubation period of 5 min (4.0 +/- 2.3 vs 6.2 +/- 4.2, P < 0.05) and during the entire study period (10.8 +/- 3.9 vs 16.5 +/- 5.6, P < 0.001).
CONCLUSIONS
Preoperative laryngeal and intratracheal spraying with 1.5 mg/kg of 10% lidocaine spray is effective for attenuation of arterial pressure increase to SL and suppression of coughing during extubation.