Effects of Oropharyngeal Lidocaine Spray Before Endotracheal Intubation on Heart Rate, Blood Pressure, and Arrhythmia in Patients Undergoing Coronary Artery Bypass Grafting Surgery: A Randomized Clinical Trial

Abstract

Background: Coronary artery disease is a growing disease in human societies. A considerable number of patients ultimately require coronary artery bypass graft (CABG) surgery. Laryngoscopy and endotracheal intubation in these patients may lead to increased heart rate (HR) and blood pressure (BP), which can exacerbate myocardial ischemia. This study aimed to investigate the potential effect of local lidocaine administration before endotracheal intubation on reducing atrial fibrillation attacks, BP changes, HR, length of hospital stay, and mortality in patients undergoing CABG surgery. Methods: In this randomized controlled clinical trial, a total of 60 candidates for CABG surgery were randomly divided into a lidocaine spray (LS) group with 30 patients and a control (C) group. Patients were randomly assigned to two groups by using computer software. In the LS group, two puffs of 10% LS were used before anesthesia induction and two puffs during laryngoscopy for endotracheal intubation. Distilled water spray was used in the C group. Mean arterial pressure (MAP) and HR at baseline (T0), one minute after anesthesia induction (T1), and in timeline durations after endotracheal intubation were measured and recorded. Finally, the patients were monitored for atrial fibrillation, length of stay in the intensive care unit (ICU), and in-hospital mortality. Results: The frequency of atrial fibrillation, length of hospital stay, and hospital mortality in patients receiving LS and the C group did not have a significant difference (P>0.05). The HR was significantly lower in patients in the LS group than in the C group two (T4), three (T5), five (T7), and ten (T8) minutes after intubation. Conclusion: This study showed that patients who received LS before intubation had better hemodynamic stability and a lower chance of tachycardia.