Endotracheal tube cuff lidocaine is not superior to intravenous lidocaine in short pediatric surgeries

Behzadi, Mehrdad; Hajimohamadi, Fatemeh; Alagha, Afshar Etemadi; Abouzari, Mehdi; Rashidi, Armin

doi:10.1016/j.ijporl.2010.01.025

Cited by 14 publications

(13 citation statements)

References 12 publications

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“…In children undergoing adenotonsillectomy, the use of non‐alkalinised lidocaine 2% in tracheal tube cuffs was compared with intravenous administration of lidocaine 1.5 mg.kg −1 . The incidence of coughing was higher in the group with lidocaine‐filled cuffs, but no significant differences in haemodynamic changes or the incidence of laryngospasm were observed between the groups . In that study, the lack of benefit from the lidocaine‐filled cuffs, could be due to the duration of surgery, which was relatively short and probably did not allow enough time for diffusion of lidocaine through the cuff membrane.…”

Section: Discussionmentioning

confidence: 69%

The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial

et al. 2016

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We studied the effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes during tracheal extubation and postoperative laryngotracheal morbidity in children. We randomly allocated 164 children aged 3-13 years undergoing general anaesthesia to one of four groups; tracheal tube cuffs filled with air (n = 41); saline (n = 41); alkalinised lidocaine 0.5% (n = 41); or alkalinised lidocaine 1% (n = 41). Intracuff pressure was monitored and maintained below 20 cmH O. The mean (SD) increases in systolic blood pressure after tracheal extubation compared with before extubation were 10.9 (10.8) mmHg, 7.3 (17.7) mmHg, 4.1 (10.5) mmHg and 1.9 (9.5) mmHg in the air, saline, 0.5% and 1% alkalinised lidocaine groups, respectively (p = 0.021). The mean (SD) increases in diastolic blood pressure after tracheal extubation compared with before extubation were 3.9 (9.7) mmHg, 7.9 (14.6) mmHg, 0.7 (10.4) mmHg and 3.6 (6.9) mmHg in the air, saline, 0.5% and 1% alkalinised lidocaine groups, respectively (p = 0.019). The mean (SD) increases in heart rate after tracheal extubation compared with before extubation were 14.2 (7.6) beats.min , 15.5 (13.1) beats.min , 5.2 (9.6) beats.min and 4.1 (6.6) beats.min in the air, saline, 0.5% and 1% alkalinised lidocaine groups, respectively (p < 0.001). The incidence of sore throat 8 h after tracheal extubation was 22.0% in the air-filled group, 9.8% in the saline group, 4.9% in the 0.5% alkalinised lidocaine group and 2.4% in the 1% alkalinised lidocaine group, p = 0.015. We conclude that filling the tracheal tube cuff with alkalinised lidocaine-filled reduces the haemodynamic response to tracheal extubation and postoperative laryngotracheal morbidity in children.

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Section: Discussionmentioning

confidence: 69%

The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial

et al. 2016

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“…Due to its short half-life, however, lidocaine given prior to intubation cannot inhibit hemodynamic responses during extubation following a long operation. Moreover, endotracheal tube cuff lidocaine was not superior to intravenous lidocaine [19]. Laryngotracheal instillation of lidocaine for topical anesthesia during extubation may increase the risk of postoperative aspiration and costs to patients [16].…”

Section: Discussionmentioning

confidence: 99%

Local Airway Anesthesia Attenuates Hemodynamic Responses to Intubation and Extubation in Hypertensive Surgical Patients

Meng

Cui

2014

Med Sci Monit

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BackgroundThe aim of this study was to evaluate the effects of topical ropivacaine anesthesia on hemodynamic responses during intubation and extubation of hypertensive patients.Material/MethodsOne hundred fifty patients with hypertension ASA II–III were scheduled for noncardiac operations. Patients were divided into 3 groups: a control group receiving 5 ml saline, and 2 groups receiving topical anesthesia with 100 mg lidocaine or 37.5 mg ropivacaine. Hemodynamic responses, including blood pressure and heart rate (HR), were recorded at baseline (T0), before intubation (T1), during tracheal intubation (T2), 2 min after intubation (T3), upon eye opening on verbal commands (T4), during tracheal extubation (T5), and 2 min after extubation (T6). Patients were injected with urapidil 5 mg during intubation and extubation if their systolic blood pressure (SBP) was ≥160 mmHg or diastolic blood pressure (DBP) was ≥90 mmHg, and esmolol 10 mg when HR was ≥90 bpm.ResultsDuring extubation, the total dosages of urapidil and esmolol were significantly higher in the saline than in the lidocaine or ropivacaine groups, and were significantly lower in the ropivacaine than in the lidocaine group. At T2, SBP, SBP, MAP, and HR were lower in the lidocaine and ropivacaine groups than in the saline group, but the differences were not significant. From T4 to T6, SBP, DBP, MAP, and HR were significantly lower in the ropivacaine group than in the other 2 groups (P<0.05 each).ConclusionsTopical lidocaine and ropivacaine anesthesia can effectively reduce hemodynamic responses during intubation, with ropivacaine better at inhibiting hemodynamic changes at emergence in hypertensive patients.

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“…62 Some articles have confirmed the efficacy of lidocaine for preventing postextubation laryngospasm, whereas others have found the opposite results to be true. 16,[63][64][65] A recent, well-conducted, randomized placebocontrolled trial in children undergoing cleft palate surgery demonstrated the effectiveness of IV lidocaine (1.5 mg/kg administered 2 min after tracheal extubation) in reducing laryngospasm and coughing (by 29.9% and 18.92%, respectively). 64 However, these favorable results were not confirmed in other studies.…”

Section: Pharmacologic Agentsmentioning

confidence: 99%

Case Scenario

et al. 2012

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This article has been selected for the ANESTHESIOLOGY CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue. P ERIOPERATIVE laryngospasm is an anesthetic emergency that is still responsible for significant morbidity and mortality in pediatric patients. 1 It is a relatively frequent complication that occurs with varying frequency dependent on multiple factors. 2-5 Once the diagnosis has been made, the main goals are identifying and removing the offending stimulus, applying airway maneuvers to open the airway, and administering anesthetic agents if the obstruction is not relieved. The purpose of this case scenario is to highlight key points essential for the prevention, diagnosis, and treatment of laryngospasm occurring during anesthesia.

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Endotracheal tube cuff lidocaine is not superior to intravenous lidocaine in short pediatric surgeries

Cited by 14 publications

References 12 publications

The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial

The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial

Local Airway Anesthesia Attenuates Hemodynamic Responses to Intubation and Extubation in Hypertensive Surgical Patients

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