Effects of lidocaine and magnesium sulfate in attenuating hemodynamic response to tracheal intubation: single-center, prospective, double-blind, randomized study

Abstract

Magnesium sulfate and lidocaine have good efficacy and safety for hemodynamic management in laryngoscopy and intubation.

Bispectral index guided attenuation of hemodynamic and arousal response to endotracheal intubation using magnesium sulfate and fentanyl. Randomized, controlled trial

“…HR increased following infusion of magnesium compared to baseline value, although clinically insignificant, which was due to inhibition of acetylcholine release from vagal nerve endings. Similar results were reported in previous studies [17][18][19] despite different doses used 20, 30, and 60 mg/kg. No significant hypotension, bradycardia, tachycardia, or arrhythmia requiring treatment occurred probably because drugs were given as infusion as slow administration of magnesium over >10 min reduces incidence of cardiovascular side effects [20].…”

Lidocaine: A Key-Factor to Avoid the Postponement of an Oncologic Urgent Surgery

“…When used systemically, it works by blocking sodium and NMDA channels, by reducing P substance release and by increasing the glycinergic activity (inhibitory neurotransmission) [4]. Lidocaine also acts on voltage-dependent potassium (decreasing pain intensity, inflammatory response and cell injury secondary to tissue ischemia) and calcium channels (this inhibition in pre-synaptic nervous terminals is highly involved with the release of neurotransmitters and so interferes with painful impulse propagation) with less affinity as compared to blockade produced in sodium channels [5].…”

“…It is well known, the lidocaine role on hemodynamic stability, using 1-1.5 mg/Kg intravenously before laryngoscopy [2,4,6]. By allowing the control of the gag reflex, it minimizes the consequences of the massive catecholamines realease and reduces the perioperative risk [4].…”

Comparison of hemodynamic responses to endotracheal intubation with the GlideScope video laryngoscope and Macintosh laryngoscope in patients undergoing cardiovascular surgery

“…Lidocaine also inhibits N-methyl-D-aspartate (NMDA) receptors. [17] Intravenous administration of lidocaine is recommended for reducing hemodynamic responses to intubation, attenuation of cough reflexes, and intracranial and intraocular pressure. [18] Many studies have been conducted to reveal its effects on hemodynamic response to intubation.…”

“…However dose of lidocaine varies from 1.5 to 2 mg/kg. [17,18] We preferred to use 0.5-1 mg/kg dose in our clinical practice for induction of anesthesia in both cardiac and non-cardiac surgery. In our study we preferred to use 1 mg/kg for induction for standardization.…”