Effect of Intralaryngotracheal 10% Lidocaine Spray on Blood Pressure and Heart Rate Changes during Endotracheal Intubation for Patients with a Cerebral Aneurysm.

Kim,  Sae Yeon; Lee,  Yong Hwan

doi:2002.42.3.298

Clinical Research Article

Korean Journal of Anesthesiology 2002;42(3):298-305.
DOI: https://doi.org/10.4097/kjae.2002.42.3.298

Effect of Intralaryngotracheal 10% Lidocaine Spray on Blood Pressure and Heart Rate Changes during Endotracheal Intubation for Patients with a Cerebral Aneurysm.

Sae Yeon Kim, Yong Hwan Lee

Department of Anesthesiology, College of Medicine, Yeungnam University, Daegu, Korea. sykim@med.yu.ac.kr

Abstract

BACKGROUND
The large hemodynamic response induced by laryngoscopy and endotracheal intubation may cause serious cerebral complications. This study was performed to evaluate the effects of intralaryngotracheal 10% lidocaine spray on hemodynamic responses to endotracheal intubation for patients with a cerebral aneurysm.
METHODS
Sixty patients with a cerebral aneurysm were randomly divided into three groups by lidocaine administration methods before endotracheal intubation: Group 1 (Control, 2% lidocaine 1.5 mg/kg, intravenous injection); Group 2 (10% lidocaine 1 mg/kg, intralaryngotracheal spray); Group 3 (10% lidocaine 1.5 mg/kg, intralaryngotracheal spray). Anesthesia was induced intravenously with midazolam (0.02 mg/kg) and thiopental sodium (2 - 3 mg/kg), and then maintained with 50% nitrous oxide in oxygen and 1.0 vol% isoflurane. Blood pressure and heart rate were measured preinduction, before laryngoscopy, immediately after epiglottis elevation, immediately after intubation and 3 minutes after intubation. Data were compared and analyzed within and between groups.
RESULTS
Immediately after intubation, the increase in blood pressure and heart rate were blunted significantly in the groups 2 and 3 compared to the intravenous lidocaine injection group (P < 0.01). However, there were no significant hemodynamic changes between groups 2 and 3.
CONCLUSIONS
The elevation of blood pressure and heart rate after endotracheal intubation can be prevented by intralaryngotracheal spray of 1 mg/kg of 10% lidocaine 3 minutes before endotracheal intubation.

Key Words: Blood pressure; endotracheal intubation; heart rate; intralaryngotracheal spray; lidocaine