Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation

Abstract Study Objective To determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation. Design Prospective, randomized, double-blind, placebo-controlled study. Setting Operating room of a university hospital. Patients 56 ASA physical status I and II adult patients scheduled for elective surgery requiring orotracheal intubation and general anesthesia. Interventions Patients were randomized to receive oropharyngeal instillation with either 5 mL 2% lidocaine (n = 28, lidocaine group) or 5 mL normal saline (n = 28, control group) 45 seconds after anesthetic induction bolus. Orotracheal intubation was attempted three minutes later. Measurements Systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at baseline, just before intubation, and for three minutes postintubation at one-minute intervals. Occurrence of adverse events such as arrhythmias, ischemic changes in electrocardiography, and bronchospasm after intubation were also documented. Main Results All postintubation values of SBP, DBP, MAP, and HR were significantly lower in the lidocaine group than the control group ( P P P Conclusion Oropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.