Korean J Crit Care Med.
2011 Jun;26(2):89-93. 10.4266/kjccm.2011.26.2.89.
Optimal Timing of Topical Lidocaine Spray on the Hemodynamic Change of Tracheal Intubation
- Affiliations
-
- 1Department of Anesthesiology and Pain Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. kimst@chungbuk.ac.kr
- 2Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 3Department of Emergency Medical Service, Chungju National University, Jeungpyeong, Korea.
- KMID: 1977491
- DOI: http://doi.org/10.4266/kjccm.2011.26.2.89
Abstract
- BACKGROUND
Tracheal intubation stimulates the sympathetic nervous system, resulting in hypertension, tachycardia and sometimes critical complications, especially in patients with underlying hypertension, cardiovascular disease or cerebrovascular disease. In this study, we sprayed 4% lidocaine into the trachea before intubation, and observed the hemodynamic changes after tracheal intubation.
METHODS
We randomly allocated 87 patients, whose ASA physical status was I or II, into three groups. The 4% topical lidocaine was sprayed before intubation at the following specific times: just before intubation (group 0), or 1 minute (group 1) and 2 minutes before intubation (group 2). For maintenance of anesthesia, TIVA (total intravenous anesthesia; propofol-remifentanil infusion with orchestra(R)) was used. We observed hemodynamic changes between the groups just after the intubation, as well as 1, 3 and 5 minutes after the intubation. Hemodynamic changes were also monitored in the same group.
RESULTS
When the patients arrived at the operating room, we found no significant difference in heart rate and arterial pressure between the groups. However, heart rate after intubation in group 1 was significantly lower than group 0. The diastolic and mean arterial pressure just after intubation were lower in group 1 and 2 than in group 0.
CONCLUSIONS
Spraying lidocaine 1 or 2 minutes before intubation was more effective than spraying it just before intubation for reducing hypertensive responses after intubation.
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