The Effect of 10 % Lidocaine Spray on Hemodynamic, the Incidence of Cough and Postoperative Sore Throat Accompanied by Endotracheal Intubation
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Abstract
Background: Laryngoscopy and endotracheal intubation are potential stimuli that can frequently induce increased sympathetic activity, cough and postoperative sore throat. Furthermore cough and hyperdynamic reaction cause considerable discomfort, and they may lead to postoperative surgical complication. To reduce coughing and hemodynamic during emergence, the efficacy of pharyngolaryngeal spraying with lidocaine before intubation is not clear.
Objective: To study the effect of 10 % lidocaine (Xylocaine® 10 % Spray, Astra, Sweden) spray on hemodynamic responses, the incidence of cough and postoperative sore throat after laryngoscopy and endotracheal intubation. The efficacy of 10% lidocaine spray to pharyngolaryngeal for reducing these symtomps is unclear.
Study design: Prospective, randomized controlled trial.
Methods: Seventy two ASA I patients undergoing elective surgery were allocated random to two groups. Control group was intubated without 10 % lidocaine spray. Study group was intubated with 10 % lidocaine spray to pharyngolaryngeal site 2 puff during the induction of anesthesia. Mean arterial blood pressure, heart rate, arrhythmia were recorded. During emergence, patients were observed their cough and hemodynamics.
Results: Compared with the control group, mean arterial blood pressure was significantly decrease in 10 % lidocaine spray group at immediately post intubation, 3 minutes and 5 minutes after intubation. An increase in heart rate was significantly decrease in 10 % lidocaine spray groups at 3 minutes and 5 minutes after intubation. But the incidence of arrhythmia and postoperative sore throat were not different between two groups. Lidocaine spray did not significantly diminish the cough and the hemodynamic reaction across the groups before and after the extubation as well as in the recovery room.
Conclusions: The elevation of blood pressure and an increase in heart rate accompanied by endotracheal intubation can be prevented with 10 % lidocaine spray to pharyngolaryngeal site before intubation. But lidocaine spray does not reduce sore throat, cough and hemodynamic reactions during emergence from general anesthesia.
Keywords: Anesthetics, local : lidocaine, intubation, cough, emergence
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References
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