Lidocaine Does Not Prevent Bispectral Index Increases in Response to Endotracheal Intubation

Abstract

We investigated the effect of IV lidocaine on the hemodynamic and bispectral index responses to induction of general anesthesia and endotracheal intubation. Forty patients (ASA I) were randomly allocated into 2 groups of 20 to receive normal saline or lidocaine 1.5 mg/kg IV 30 s after induction. Ninety seconds later, endotracheal intubation was performed. Systolic blood pressure, heart rate, and bispectral index were measured at baseline, 1 min after induction, at preintubation, and every minute until 5 min after endotracheal intubation. Bispectral index at 1 min after induction and preintubation in the lidocaine group were significantly lower compared with the control group (P < 0.05). Systolic blood pressure increased significantly at 1 and 2 min after intubation in the control group compared with the baseline value (P < 0.05) but did not increase significantly in the lidocaine group. Heart rate increased at 1 to 3 min in both groups (P < 0.05), but there was no significant difference between the two groups. One patient in the control group had recall of the procedure. We conclude that the administration of IV lidocaine (1.5 mg/kg) does not suppress the hypnotic response to endotracheal intubation.

The effects of intravenous lignocaine on depth of anaesthesia and intraoperative haemodynamics during open radical prostatectomy

“…Numerous trials have evaluated the effects of IV lignocaine on intraoperative haemodynamics and anaesthetic requirement [12–14, 16, 18, 20–26] (Table 3). Noteworthy, some of these studies were performed in small sample of patients [26–28], whilst others failed to investigate the effects of combining a loading dose of lignocaine with a continuous infusion [24, 27]. Our findings of lower end tidal concentrations of volatile agents in the Lignocaine group provide support for the inclusion of lignocaine in the combination of pharmacological agents that may contribute to “balanced anaesthesia”.…”

Intravenous lidocaine does not affect the anesthetic depth during rapid sequence induction and intubation as assessed by Bispectral Index monitoring: a randomized double blind study

“…Lidocaine has been used in clinical practice to blunt the hemodynamic response to airway instrumentation due to its suppressive effects on airway reflexes and its antiarrhythmic properties. Nevertheless, the reports about its efficacy in attenuating the sympathetic response to intubation are contradictory [1–5]. …”

Fentanyl and fentanyl plus lidocaine on attenuation of haemodynamic stress response to laryngoscopy: a comparative study in controlled hypertensive patients posted for laparoscopic cholecystectomy

“…These beneficial effects of lidocaine on hemodynamic stability is possibly due to; direct myocardial depressant effect, peripheral vasodilating effect and the effect on synaptic transmissions. 18,19 Moreover, according to Ali et al in 2010, pre-treatment with lidocaine improves intra-and post-operative hemodynamic stability during laparoscopic surgery without prolonging recovery. 26 Our study was in line with some previous studies such as Shin et al.…”