A Comparison of Lidocaine Administration Routes for the Prevention of Hemodynamic Responses to Intubation

Park, Se Hun; Koo, Bon Up

Abstract

The aim of this study was to compare the hemodynamic responses with various administration routes of lidocatine, which was used to blunt the sympathetic stimulation associated with intubation. The study population was from 24 patients scheduled for elective open heart surgery at Yeungnam University Hospital. Patients were randomly assigned to receive lidocaine by intravenous administration, laryngotracheal spray, and oropharyngeal gargling, and endotracheal intubation was performed. Heart rate, mean arterial pressure, central venous pressure, and arterial oxygen saturation were measured at 30 seconds, 1 minute, 3 minutes and 5 minutes after intubation and compared with the control group. The results were as follows: 1) In the control group which was not administered lidocaine, heart rate and mean arterial 1pressure were significantly increased (p<0.05, p<0.01). 2) In the group of intravenous lidocaine administration, heart rate was significantly increased (p < 0.05), but mean arterial pressure was not significantly changed after endotracheal intubation. Compared with control group, the changes of heart rate and mean artrerial pressure were statistically significant (p<0.05). 3) In the group of laryngotracheal lidocaine spray, heart rate and mean arterial pressure were increased after endotracheal intubation. 4) In the group of oropharyngeal lidocaine gargling, heart rate and mean arterial pressure showed significantly increased (p<0.05, p<0.01), and heart rare mintained an increased state but mean arterial pressure was reduced to the baseline value 5 minutes following intubation. 5) Laryngotracheal spray and oropharyngeal gargling group showed more significant increase in heart rate and mean arterial pressure than intravenous administration group. 6) No significant changes were observed in central venous pressure and arterial ocygen saturation in all three groups. It is concluded that intravenous administration of lidocaine before endotracheal intubation is more effective than laryngotracheal spray or oropharyngeal gargling.