Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine

Abou-Madi, M.; Keszler, Huco; Yacoub, Joseph M.

doi:10.1007/bf03006808

Cited by 146 publications

(12 citation statements)

References 11 publications

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“…In this study, the effects of intravenous magnesium sulfate on laryngospasm after elective tonsillectomy in children were studied. Magnesium sulfate is also used for curing acute bronchospasm and severe asthma with dose of 10-25 mg/kg in children (11, 12). …”

Section: Discussionmentioning

confidence: 99%

The Effect of Intravenous Magnesium Sulfate on Laryngospasm After Elective Adenotonsillectomy Surgery in Children

et al. 2014

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Background:Laryngospasm is the protective reflex of tracheobronchial tree against secretions and hemorrhage. This reflex is more prevalent in adenotonsillectomy in the presence of light anesthesia, which can lead to obstruction of airway, complications, and mortality. Different methods have been studied for preventing this complication; however, none of them could reliably prevent it.Objectives:The objective was to assess the effect of magnesium sulfate on laryngospasm and coughing after adenotonsillectomy.Patients and Methods:Seventy children with three to 12 years of age and ASA classes I and II, who were candidates for adenotonsillectomy, were recruited in this randomized clinical trial. The study group received 15 mg/kg intravenous magnesium sulfate and the control group received 0.9% normal saline with the same volume, 2 minutes after tracheal intubation via intravenous infusion for 20 minutes. After removing the endotracheal tube in the recovery room, the patients were assessed at minutes zero, 15, and 30in terms of laryngospasm and coughing. The assessment was based on four-point scale of severity of these complications and saturation percentage of arterial oxygen in operating and recovery room. After collecting the data, results were analyzed with the SPSS 16 software anda P value < 0.05 was considered statistically significant.Results:Laryngospasm was not found in the magnesium sulfate group; however, its incidencewas5.7% in the control group. The incidence rates of coughs were 17.1% and 40% in the magnesium sulfate group and in the control group, respectively, which had no statistically significant differences.Conclusions:Intravenous magnesium sulfate with dose of 15 mg/kg could not prevent laryngospasm and coughing after removal of the endotracheal tube in patients undergoing adenotonsillectomy; however, it reduced coughing and laryngospasm in the magnesium sulfate group compared with the control group.

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Section: Discussionmentioning

confidence: 99%

The Effect of Intravenous Magnesium Sulfate on Laryngospasm After Elective Adenotonsillectomy Surgery in Children

et al. 2014

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“…[11] demonstrated that intravenous lidocaine 1 mg/kg administered two minutes before endotracheal intubation prevented coughing and increased blood pressure and heart rate, during and after extubation. In our study there was a significant increase in heart rate, systolic and diastolic blood pressure at one, two, three, five and ten minutes following extubation, in Group P. Paediatric patients with cleft palate usually have upper respiratory tract infections (URTI) and thus have hyper-reactive airways that precipitate laryngospasm.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intravenous lidocaine in prevention of post extubation laryngospasm in children undergoing cleft palate surgeries

Sanikop¹,

Bhat²

2010

Indian J Anaesth

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A one-year randomized placebo-controlled trial was conducted to study the effectiveness of intravenous lidocaine in the prevention of post extubation laryngospasm in children, following cleft palate surgeries. Children of age three months to six years were randomly assigned into two groups. Group P placebo (saline) and Group L (Lidocaine), 1.5 mg/kg. A sample size of 74 with n = 37 in each group was selected. The anaesthetic procedure was standardized. At the end of the procedure, three minutes after reversal, the study drug, that is, intravenous lidocaine (1.5 mg/kg) or placebo (saline) was administered and two minutes later the child was extubated. Following extubation for 10 minutes, the haemodynamic parameters, that is, pulse, blood pressure, oxygen saturation, severity of coughing, and laryngospasm were noted. The total reduction of laryngospasm and coughing was 29.9% and 18.92% with IV lidocaine. Significant alterations in haemodynamics and oxygen saturation were noted for 10 minutes, following extubation. Hence, intravenous lidocaine 1.5 mg/kg was effective in the prevention of post extubation laryngospasm in children undergoing cleft palate surgeries.

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“…[34] In patients with coronary artery disease, leaking abdominal aneurysm, intracranial aneurysm and recent myocardial infarction these transient changes can result in potentially deleterious effects such as myocardial ischemia, left ventricular failure and cerebral hemorrhage. [456]…”

Section: Introductionmentioning

confidence: 99%

Oral clonidine versus gabapentin as premedicant for obtunding hemodynamic response to laryngoscopy and tracheal intubation

2014

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Background:We compared the effects of oral clonidine and gabapentin as premedicant in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery.Methods:A total of 100 patients of either sex enrolled in the study were randomly divided into two groups of 50 each. Group A patients received oral clonidine 200 μg and Group B patients received oral gabapentin 900 mg, 90 min prior to induction of anesthesia.Results:Both groups were matched for age, sex weight and intubation time. Anxiety score and sedation scores before induction were significantly better in Group A as compared with Group B. Heart rate rise was obtunded in Group A except at 1 min, as compared with Group B in which tachycardia persisted even at 3 and 5 min following intubation. Mean arterial pressure was maintained below baseline at all times in Group A as compared with Group B in which significant rise (+7.55%, P < 0.001) was seen at 1 min after intubation.Conclusion:Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin.

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Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine

Cited by 146 publications

References 11 publications

The Effect of Intravenous Magnesium Sulfate on Laryngospasm After Elective Adenotonsillectomy Surgery in Children

The Effect of Intravenous Magnesium Sulfate on Laryngospasm After Elective Adenotonsillectomy Surgery in Children

Efficacy of intravenous lidocaine in prevention of post extubation laryngospasm in children undergoing cleft palate surgeries

Oral clonidine versus gabapentin as premedicant for obtunding hemodynamic response to laryngoscopy and tracheal intubation

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