@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2015;21(1):59-66
ISSN: 2252-0805 The Horizon of Medical Sciences 2015;21(1):59-66
Comparison of the Effect of LidocaineSpray on Blade of Laryngoscope with Intravenous Lidocaine on the Cardiovascular Responses to Laryngoscopy and Endotracheal Intubation
ARTICLE INFO
Article Type
Original ResearchAuthors
Hamzei A. (1 )Basiri Mogadam M. (2 )
Esmaeili M. (* )
Delshad Noghabi A. (2 )
(* ) “Student Research Committee” and “Nursing Department, Nursing & Midwifery Faculty”, Gonabad University of Medical Sciences, Gonabad, Iran
(1 ) Anesthesia & Operating Room Department, Paramedical Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(2 ) Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Science, Gonabad, Iran
Correspondence
Address: Deputy of Education & Research, Gonabad University of Medical Sciences, Near Asian Road, Gonabad, IranPhone: +985157225027
Fax: +985157220578
Article History
Received: January 13, 2015Accepted: March 19, 2015
ePublished: April 16, 2015
ABSTRACT
Aims
Endotracheal intubation is an invasive technique which is associated with severe
cardiovascular complications. This study aimed to compare the effects of lidocaine 10%
spray on the laryngoscope blade with intravenous lidocaine on cardiovascular responses to
laryngoscopy and intubation in elective surgical patients.
Materials & Methods In this clinical trial that is performed in 2013, 90 candidates of elective surgery in Gonobad City, Iran hospitals were randomly divided to three groups; control (no drugs were used), intravenous lidocaine (three minutes before laryngoscopy) and lidocaine 10% (just before laryngoscopy). Heart rate and systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded immediately before, immediately after, and 1, 3 and 5min after laryngoscopy. Data were analyzed using SPSS 20 by repeated ANOVA and Tukey post hoc tests.
Findings There were significant differences in systolic, diastolic and mean arterial blood pressure between control group and each intravenous lidocaine and lidocaine 10% groups after laryngoscopy (p<0.001). There was no significant difference in any of the three variables between intravenous and spray groups. No significant difference was found between the three groups in heart rate (p=0.16).
Conclusion Compared with intravenous lidocaine administration, lidocaine 10% spray on the laryngoscope blade lead to better stability in blood pressure after laryngoscopy, but has no effect on the heart rate.
Materials & Methods In this clinical trial that is performed in 2013, 90 candidates of elective surgery in Gonobad City, Iran hospitals were randomly divided to three groups; control (no drugs were used), intravenous lidocaine (three minutes before laryngoscopy) and lidocaine 10% (just before laryngoscopy). Heart rate and systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded immediately before, immediately after, and 1, 3 and 5min after laryngoscopy. Data were analyzed using SPSS 20 by repeated ANOVA and Tukey post hoc tests.
Findings There were significant differences in systolic, diastolic and mean arterial blood pressure between control group and each intravenous lidocaine and lidocaine 10% groups after laryngoscopy (p<0.001). There was no significant difference in any of the three variables between intravenous and spray groups. No significant difference was found between the three groups in heart rate (p=0.16).
Conclusion Compared with intravenous lidocaine administration, lidocaine 10% spray on the laryngoscope blade lead to better stability in blood pressure after laryngoscopy, but has no effect on the heart rate.
Keywords:
Laryngoscopes,
Lidocaine,
Cardiovascular System,
Endotracheal Intubation,
Elective Surgical Procedures,
CITATION LINKS
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[2]Habib AS, Parker JL, Maguire AM, Rowbotham DJ, Thompson JP. Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly. Br J Anaesth. 2002;88(3):430-3.
[3]Alijanpour E, Amry P, Rezaei Moghaddam A, Bijani A. Comparison of intravenous magnesium sulfate and lidocaine on hemodynamic changes during intubation. J Babol Univ Med Sci. 2006;8(4):20-5. [Persian]
[4]Kovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996;8(1):63-79.
[5]Akhavan Akbari Gh, Entezari Asl M, Amani F. Comparing the effects of remifentanil and alfentanil on the cardiovascular responses to the induction of anesthesia and tracheal intubation in elderly patients. J Ardabil Univ Med Sci. 2006;6(3):220-6. [Persian]
[6]Gupta S, Tank P. A comparative study of efficacy of esmolol and fentanyl for pressure attenuation during laryngoscopy and endotracheal intubation. Saudi J Anaesth. 2011;5(1):2-8.
[7]Miller RD, Stoelting RK. Basics of Anesthesia. 5th edition. London: Churchill Livingstone; 2006. p. 201-2.
[8]Hines RL, Marschall KE. Stoelting's anesthesia and coexisting disease. 5th edition. Philadelphia: Saunders; 2008. pp. 55-6.
[9]Parviz-Kazemei A, Kamalipour H. Comparison of the effects of topical lidocaine spray applied oropharyngealy before and hypopharyngealy after induction of anesthesia on the presser response to direct laryngoscopy and intubation. J Gorgan Uni Med Sci. 2004;6(1):17-22. [Persian]
[10]Helfman SM, Gold MI, Delisser EA, Hemngton ClA. Prevention of tachycardia and hypertension associated with tracheal intubation. Anesth Analgesia. 1991;73(4):503-4.
[11]Helfman SM, Gold MI, DeLkser EA, Herrington CA. Which drug prevents tachycardia and hypertension associated with tracheal intubation: Lidocaine, fentanyl or esmolol? Anesth Analgesia. 1991;72(4):482-6.
[12]Rathore A, Gupta HK, Tanwar GL, H Rehman H. Attenuation of the pressure response to laryngoscopy and endotracheal intubation with different doses of esmolol. Ind J Anaesth. 2002;46(6):449-52.
[13]Stone DJ, Gal TJ. Airway management. In: Miller R, editor. Anesthesia. 5th edition. Volume 1. Philadelphia: Churchill livingstone; 1999.
[14]Stoelting RK. Circulatory response to laryngoscopy and tracheal intubation with or without prior oropharyngeal viscous lidocaine. Anesth Analgesia. 1977;56(5):618-21.
[15]Takeshima K, Noda K, Higaki M. Cardiovascular response to rapid anesthesia induction and endotracheal intubation. Anaesth Analgesia. 1964;43(2):201-8.
[16]Butterworth JF, Strichartz GR. Molecular mechanisms of local anesthesia: A review. Anesthesiology. 1990;72(4):711-34.
[17]Youngsberg JA, Graybar G, Hutchings D. Comparison of intravenous and topical lidocaine in attenuating the cardiovascular responses to endotracheal intubation. South Med J. 1983;76(9):1122-4.
[18]Williams KA, Barker GL, Harwood RJ, Woodall NM. Combined nebulization and spray-as-you-go topical local anaesthesia of the airway. Br J Anaesthesia. 2005;95(4):549-53.
[19]Takita K, Morimoto Y, Kemmotsu O. Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation. Can J Anaesth. 2001;48(8):732- 6.
[20]Park YO, Bang KS, Choi EM, Hong SJ, Kim IS, Shin KM, et al. Plasma lidocaine concentration and hemodynamic effect after 10% lidocaine spray on laryngopharyngeal and intratracheal site during the endotracheal intubation. Korean J Anesthesiol. 2005;49(2):152-6.
[21]Laurito CE, Baughman VL, Becker GL, Polek WV, Riegler FX, VadeBoncouer TR. Effects of aerosolized and/or intravenous lidocaine on hemodynamic responses to laryngoscopy and intubation in outpatients. Anesth Analgesia. 1988;67(4):389-92.
[22]Mostafa SM, Murthy BV, Barrett PJ, McHugh P. Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia on the pressor response to direct laryngoscopy and intubation. Eur J Anesthesiology. 1999;16(1):7-10.
[23]Hung O, Murphy M. Management of the difficult and failed airway. 2nd edition. New York: McGraw-Hill Professional; 2011. pp. 40-1.
[24]Gobel FL, Norstrom LA, Nelson RR, Jorgensen CR, Wang Y. The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris. 1978;57(3):549-56.
[25]Lee KS, Shin HJ, Tak YJ, Tae S. Optimal timing of topical lidocaine spray on the hemodynamic change of tracheal intubation. Korean J Crit Care Med. 2011;26(2):89-93.
[26]Sarasen P, Leesan A. The effect of 10% lidocaine spray on the hemodynamic, the incidence of cough and postoperative sore throat accompanied by endotracheal intubation. Yasothon Med J. 2010;12(2):83-91. [Thai]
[27]Qureshi FM, Padmanabha S, Rahaman H, Imran Sh, Mohan PR. Efficacy and optimal time of oropharyngeal topical 10% lignocaine spray before induction of anaesthesia in attenuating the pressor response to direct laryngoscopy and endotracheal intubation. IOSR J Dental Med Sci. 2013;9(6):57-63.
[28]Safavi M, Honarmand A. A comparison of different doses of remifentanil and tracheal lidocaine on attenuation of cardiovascular responses to laryngoscopy and tracheal intubation. Turkish J Med Sci. 2009;39(3):439-45.
[29]Jain M, Gurcoo S, Shora A, Qazi M, Dar B, Buchh V, Ahmad S. Efficacy of topical lignocaine spray (10%) applied before the induction of anaesthesia in attenuating the pressor response to direct laryngoscopy and endotracheal intubation in controlled hypertensive patients. Int J Anesthesiol. 2009;20(2):18-22.
[30]Lee DH, Park SJ. Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation. Korean J Anesthesiol. 2011;60(6):422–7.
[2]Habib AS, Parker JL, Maguire AM, Rowbotham DJ, Thompson JP. Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly. Br J Anaesth. 2002;88(3):430-3.
[3]Alijanpour E, Amry P, Rezaei Moghaddam A, Bijani A. Comparison of intravenous magnesium sulfate and lidocaine on hemodynamic changes during intubation. J Babol Univ Med Sci. 2006;8(4):20-5. [Persian]
[4]Kovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996;8(1):63-79.
[5]Akhavan Akbari Gh, Entezari Asl M, Amani F. Comparing the effects of remifentanil and alfentanil on the cardiovascular responses to the induction of anesthesia and tracheal intubation in elderly patients. J Ardabil Univ Med Sci. 2006;6(3):220-6. [Persian]
[6]Gupta S, Tank P. A comparative study of efficacy of esmolol and fentanyl for pressure attenuation during laryngoscopy and endotracheal intubation. Saudi J Anaesth. 2011;5(1):2-8.
[7]Miller RD, Stoelting RK. Basics of Anesthesia. 5th edition. London: Churchill Livingstone; 2006. p. 201-2.
[8]Hines RL, Marschall KE. Stoelting's anesthesia and coexisting disease. 5th edition. Philadelphia: Saunders; 2008. pp. 55-6.
[9]Parviz-Kazemei A, Kamalipour H. Comparison of the effects of topical lidocaine spray applied oropharyngealy before and hypopharyngealy after induction of anesthesia on the presser response to direct laryngoscopy and intubation. J Gorgan Uni Med Sci. 2004;6(1):17-22. [Persian]
[10]Helfman SM, Gold MI, Delisser EA, Hemngton ClA. Prevention of tachycardia and hypertension associated with tracheal intubation. Anesth Analgesia. 1991;73(4):503-4.
[11]Helfman SM, Gold MI, DeLkser EA, Herrington CA. Which drug prevents tachycardia and hypertension associated with tracheal intubation: Lidocaine, fentanyl or esmolol? Anesth Analgesia. 1991;72(4):482-6.
[12]Rathore A, Gupta HK, Tanwar GL, H Rehman H. Attenuation of the pressure response to laryngoscopy and endotracheal intubation with different doses of esmolol. Ind J Anaesth. 2002;46(6):449-52.
[13]Stone DJ, Gal TJ. Airway management. In: Miller R, editor. Anesthesia. 5th edition. Volume 1. Philadelphia: Churchill livingstone; 1999.
[14]Stoelting RK. Circulatory response to laryngoscopy and tracheal intubation with or without prior oropharyngeal viscous lidocaine. Anesth Analgesia. 1977;56(5):618-21.
[15]Takeshima K, Noda K, Higaki M. Cardiovascular response to rapid anesthesia induction and endotracheal intubation. Anaesth Analgesia. 1964;43(2):201-8.
[16]Butterworth JF, Strichartz GR. Molecular mechanisms of local anesthesia: A review. Anesthesiology. 1990;72(4):711-34.
[17]Youngsberg JA, Graybar G, Hutchings D. Comparison of intravenous and topical lidocaine in attenuating the cardiovascular responses to endotracheal intubation. South Med J. 1983;76(9):1122-4.
[18]Williams KA, Barker GL, Harwood RJ, Woodall NM. Combined nebulization and spray-as-you-go topical local anaesthesia of the airway. Br J Anaesthesia. 2005;95(4):549-53.
[19]Takita K, Morimoto Y, Kemmotsu O. Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation. Can J Anaesth. 2001;48(8):732- 6.
[20]Park YO, Bang KS, Choi EM, Hong SJ, Kim IS, Shin KM, et al. Plasma lidocaine concentration and hemodynamic effect after 10% lidocaine spray on laryngopharyngeal and intratracheal site during the endotracheal intubation. Korean J Anesthesiol. 2005;49(2):152-6.
[21]Laurito CE, Baughman VL, Becker GL, Polek WV, Riegler FX, VadeBoncouer TR. Effects of aerosolized and/or intravenous lidocaine on hemodynamic responses to laryngoscopy and intubation in outpatients. Anesth Analgesia. 1988;67(4):389-92.
[22]Mostafa SM, Murthy BV, Barrett PJ, McHugh P. Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia on the pressor response to direct laryngoscopy and intubation. Eur J Anesthesiology. 1999;16(1):7-10.
[23]Hung O, Murphy M. Management of the difficult and failed airway. 2nd edition. New York: McGraw-Hill Professional; 2011. pp. 40-1.
[24]Gobel FL, Norstrom LA, Nelson RR, Jorgensen CR, Wang Y. The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris. 1978;57(3):549-56.
[25]Lee KS, Shin HJ, Tak YJ, Tae S. Optimal timing of topical lidocaine spray on the hemodynamic change of tracheal intubation. Korean J Crit Care Med. 2011;26(2):89-93.
[26]Sarasen P, Leesan A. The effect of 10% lidocaine spray on the hemodynamic, the incidence of cough and postoperative sore throat accompanied by endotracheal intubation. Yasothon Med J. 2010;12(2):83-91. [Thai]
[27]Qureshi FM, Padmanabha S, Rahaman H, Imran Sh, Mohan PR. Efficacy and optimal time of oropharyngeal topical 10% lignocaine spray before induction of anaesthesia in attenuating the pressor response to direct laryngoscopy and endotracheal intubation. IOSR J Dental Med Sci. 2013;9(6):57-63.
[28]Safavi M, Honarmand A. A comparison of different doses of remifentanil and tracheal lidocaine on attenuation of cardiovascular responses to laryngoscopy and tracheal intubation. Turkish J Med Sci. 2009;39(3):439-45.
[29]Jain M, Gurcoo S, Shora A, Qazi M, Dar B, Buchh V, Ahmad S. Efficacy of topical lignocaine spray (10%) applied before the induction of anaesthesia in attenuating the pressor response to direct laryngoscopy and endotracheal intubation in controlled hypertensive patients. Int J Anesthesiol. 2009;20(2):18-22.
[30]Lee DH, Park SJ. Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation. Korean J Anesthesiol. 2011;60(6):422–7.