Respuesta cardiovascular a la laringoscopía en la intubación endotraqueal con lidocaina tópica vs lidocaina intravenosa. Hospital Vicente Corral Moscoso, Cuenca 2011

Abstract

Objective. Compare the use of lidocaine spray in oropharyngeal mucosa to attenuate cardiovascular response to laryngoscopy and intubation versus intravenous lidocaine.

Materials. Design is single-blind randomized controlled trial of 108 patients in two groups. The aerosol group (n ꞊ 54) received 3 sprays in oropharyngeal mucosa (30mg) 5 min prior to laryngoscopy and group IV received 1.5 mg / kg three minutes before laryngoscopy. Response was measured heart rate, blood pressure and incidence of coughing during extubation.

Results. In comparable groups sex, age, education, ASA, procedure and marital status. IV lidocaine group had significant decrease in heart rate 15 minutes of laryngoscopy and intubation (P = 0.028). In most blood pressure measurements were decreased intravenous lidocaine group but only significant diastolic pressure at 5 min after laryngoscopy and intubation (P = 0.021) and mean arterial pressure in the same time (P = 0.035). Patients whose response was attenuated by the administration of lidocaine spray was lower than in group that received the intravenous lidocaine. The difference was highly significant in the 3 parameters: heart rate, diastolic and mean arterial pressure (p <0.05)

Discussion. The administration of 1.5 mg / kg of intravenous lidocaine 3 min before laryngoscopy and intubation was 2.65 times better on heart rate, 5.2 times better on diastolic blood pressure and 4.19 times better at attenuating blood pressure average. Systolic blood pressure was not modified. DeCS: Lidocaine-therapeutic use; Lidocaine-classification; Lidocaine-administration & dosage; Intubation, Intratracheal-utilization; Laryngoscopy-utilization; Cardiovascular Physiological Processes-drug effects; Randomized Controlled Trial; Hospital Regional Vicente Corral Moscoso; Cuenca-Ecuador