Intraoperative lidocaine infusion attenuates tourniquet induced hypertension in patients undergoing anterior cruciate ligament reconstruction under general anesthesia

Abstract Objective This randomized, double blind, controlled study was designed to test whether the intraoperative use of intravenous lidocaine bolus followed by infusion would attenuate the tourniquet induced hypertension (TIH) in patients undergoing anterior cruciate ligament reconstruction (ACLR) under general anesthesia. Methods 76 patients were randomly allocated into two equal groups. Lidocaine group (group L), in which patients received lidocaine 2% 1 mg/kg IV bolus after induction of anesthesia followed by lidocaine infusion (2 mg/kg/h) and placebo group (group P), in which patients received equal volumes of saline. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded before induction of anesthesia, before tourniquet inflation (baseline value), every 15 min after tourniquet inflation, and after tourniquet deflation. The number of patients who developed TIH was recorded and total amount of propofol and fentanyl used intraoperative was recorded. Results SBP, DBP and HR were significantly less after tourniquet inflation in group L compared to group P in most of the time periods after tourniquet inflation ( p value  p value 0.019), and the total amount of propofol and fentanyl used intraoperative was significantly less in group L compared to group P ( p value 0.000). Conclusion Intraoperative use of lidocaine bolus (1 mg/kg), followed by infusion (2 mg/kg/h), started 10 min before tourniquet inflation attenuated the TIH in patients undergoing anterior cruciate ligament reconstruction under general anesthesia.