The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis

Qi, Xiaojing; Lai, Zhoupeng; Li, Si; Liu, Xiaochen; Wang, Zhongxing; Tan, Wulin

doi:10.1038/srep32308

Cited by 19 publications

(10 citation statements)

References 23 publications

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“…A bolus of 2 mg/kg of intravenous lidocaine has been shown to reduce the rate of laryngospasm elicited by intentional stimulation of the glottis by distilled water but this effect is short lived 30 . Additionally, a meta‐analysis has demonstrated that topical or intravenous lidocaine is effective at reducing or preventing laryngospasm in children 31 . The major limitations of this meta‐analysis, however, were the relatively low incidence of laryngospasm overall and the fact that anesthesiologists were commonly not blinded to the study group, which alone may have introduced significant reporting bias.…”

Section: Main Articlementioning

confidence: 99%

Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia—Part 2: Anesthesia‐related risk and treatment options

Templeton

Sommerfield

Hii

et al. 2021

Pediatric Anesthesia

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Perioperative respiratory adverse events are the most common cause of critical events in children undergoing anesthesia and surgery. While many risk factors remain unmodifiable, there are numerous anesthetic management decisions which can impact the incidence and impact of these events, especially in at-risk children. Ongoing research continues to improve our understanding of both the influence of risk factors and the effect of specific interventions. This review discusses anesthesia risk factors and outlines strategies to reduce the rate and impact of perioperative respiratory adverse events with a chronologic based inquiry into anesthetic management decisions through the perioperative period from premedication to postoperative disposition.

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Section: Main Articlementioning

confidence: 99%

Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia—Part 2: Anesthesia‐related risk and treatment options

Templeton

Sommerfield

Hii

et al. 2021

Pediatric Anesthesia

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“…75,77 In addition, the use of intravenous or laryngotracheal topical lidocaine has been demonstrated to decrease the risk of laryngospasm in both children and adults. 78,79…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures

Din‐Lovinescu

Trivedi

Zhang

et al. 2020

Ann Otol Rhinol Laryngol

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Objective(s): Negative pressure pulmonary edema (NPPE) is a rare perioperative complication with a potentially fatal outcome. The aim of this study was to perform a systematic review of NPPE in adult otolaryngology procedures with the goal of identifying risk factors, clinical presentation, diagnosis, management and outcomes. Methods: Systematic review performed using PubMed, Scopus, Web of Science, and Cochrane databases. Results: Sixty-nine studies including data from 87 individual patients were included in this review. Fifty-six (68%) patients were male and the average patient age was 37 years old. Type 1 NPPE occurred in 63 (72%) cases, while type 2 NPPE accounted for 20 (23%) cases. The most common procedures leading to NPPE were septoplasty, rhinoplasty or sinus surgery (n = 22, 25%), directly laryngoscopy or bronchoscopy (n = 13, 15%), and tracheostomy or cricothyroidotomy (n = 11, 13%). The most employed treatment options included diuretics (n = 55, 63%) and mechanical ventilation (n = 54, 62%). Seventy-eight (90%) patients made a full recovery with an average time to NPPE resolution of 33 hours and an average length of hospitalization of 5.6 days. Five (6%) patients had a long-term morbidity and four (5%) patients died, with age and ICU stay increasing risk for death and long-term morbidity (OR 1.044 and 7.42, respectively, P < .05). Conclusion: Septoplasty, rhinoplasty and sinus surgery account for the majority of NPPE cases in adult otolaryngology procedures. Young, healthy patients are the most commonly involved with a slight male predominance. The vast majority of patients recover fully, however there is a significant risk for morbidity and mortality.

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“…11 Topical and IV lidocaine has blunted the incidence of laryngospasm and cough response in people and dogs, respectively. 12,13 Abolition of laryngeal response based on electromyographic studies was recorded 90-120 s after topical application of 2% lidocaine in another study. 4 Intubation was easily performed 1.5 mins after application of 2% lidocaine and loss of response to mechanical stimulation after 1.95 mins.…”

Section: Discussionmentioning

confidence: 99%

“…11 Topical and IV lidocaine has blunted the incidence of laryngospasm and cough response in people and dogs, respectively. 12,13…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the time to desensitization of the larynx of cats following topical lidocaine application

Jones

Boyer

Chapman

et al. 2020

Journal of Feline Medicine and Surgery

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Objectives The objective of this study was to evaluate the time to decreased reactivity of the arytenoid cartilages in cats after application of topical lidocaine. Methods One hundred and ten mixed-breed cats were randomly assigned to one of five groups based on the time between application of lidocaine and stimulation of the larynx: 5 (T5), 15 (T15), 30 (T30), 45 (T45) or 60 (T60) s. Cats were premedicated with dexmedetomidine, ketamine and buprenorphine. Anesthesia was induced with propofol to effect. Lidocaine 2% (2 mg/kg) was applied topically to the vocal cords using a catheter attached to a syringe under direct laryngoscopy. After lidocaine application, the designated time elapsed and the vocal cords were stimulated with the patient end of an endotracheal tube. Severity of reaction was reported as none, mild, moderate or severe. All cats were intubated after the reactivity score was recorded. Anesthesia was maintained with isoflurane and 100% oxygen while cats were spayed or neutered. Cats were monitored in recovery for signs of respiratory complications and pain. Results There was a significant difference in overall reactivity score between T5 and T45 ( P = 0.0038). Also, there was a significant difference in the number of cats with no reaction compared with cats with any reaction between T5 and T30 ( P = 0.03), as well as between T5 and T45 ( P = 0.0028). No cat had a severe reactivity score at T45 or T60. All cats were successfully intubated. There were no complications during intubation, maintenance of anesthesia or recovery. Conclusions and relevance As the lowest overall reactivity score occurred at T45, it is recommended to wait at least 45 s after application of topical lidocaine before attempting tracheal intubation.

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The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis

Cited by 19 publications

References 23 publications

Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia—Part 2: Anesthesia‐related risk and treatment options

Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia—Part 2: Anesthesia‐related risk and treatment options

Systematic Review of Negative Pressure Pulmonary Edema in Otolaryngology Procedures

Evaluation of the time to desensitization of the larynx of cats following topical lidocaine application

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