Philippine E-Journals

Efficacy of Intravenous Lidocaine in Attenuating Hemodynamic Responses during Laryngoscopy and Intubation

Annabelle M. Sinlao | Monique M. Yoingco

 

Abstract:

Direct laryngoscopy and endotracheal intubation after induction of general anesthesia are frequently associated with hypertension and tachycardia. This post intubation response is potentially harmful in patients with preoperative hypertension, cardiovascular disease and increase in intracranial pressure. Objective: The goal of this study is to determine the efficacy of intravenous lidocaine administration in attenuating the hemodynamic responses during endotracheal intubation. Methods: This is a prospective, double blind, randomized controlled trial conducted from January – March 2020 which included admitted patients for scheduled elective surgeries at MCU-FDTMF Hospital. Subjects are aged from 19-60 years, ASA I and II, with an airway assessment of Mallampati I and II. Patients were allocated randomly to three groups: Group A or the placebo which were given NSS and Group B and C with intravenous lidocaine 1.5 mg/kg administered 2 min and 1 min respectively prior to laryngoscopy and intubation. A total of 56 subjects were included in the study. Results: Analysis of data were done using ANOVA, Kruskal Wallis, and chi square test. The heart rate of those given lidocaine was significantly lower than those given NSS with the p values 0.0002, 0.0008 and 0.002 at 1 min to 5 min post intubation. There was also a significant difference noted on the systolic and diastolic blood pressure as well as mean arterial pressure on those given lidocaine than those given NSS with p values of 0.0001, 0.003, and 0.02. Pairwise comparison between Group B and C showed a significant difference which had a significant decrease in HR, SBP, DBP, and MAP to subjects given with lidocaine 1.5 mg/kg 1 min prior to intubation. Conclusion: The administration of lidocaine with a dose of 1.5 mg/kg 1 min prior to laryngoscopy and intubation is effective in suppressing hemodynamic responses significantly.