IS INTRAVENOUS LIDOCAINE AN EFFECTIVE ADJUVANT FOR ENDOTRACHEAL INTUBATION IN CHILDREN UNDERGOING INDUCTION OF ANESTHESIA WITH HALOTHANE NITROUS-OXIDE

Study Objective: To evaluate the efficacy of intravenous (IV lidocaine in suppressing the cough reflex and increases in intraocular pressure (IOP), heart rate (HR), and mean arterial pressure (MAP) elicited by endotracheal intubation.Design: Prospective, randomized, placebo-contr olled, blinded study. Patients: 60 ASA physical status I premedicated children aged 2 to 6 years undergoing induction of anesthesia with hal othane-nitrous oxide (N2O) for surgery to correct strabismus. Interven tions: Patients were randomly divided into two groups of 30 each. The control group (C) received saline and the treatment group (L) received 2 mg/kg IV lidocaine 90 seconds prior to endotracheal intubation. Mea surements and Main Results: Awake HR and MAP; IOP, HR, and MAP 45 seco nds prior to endotracheal intubation, immediately after endotracheal i ntubation, and I minute later, were recorded. Coughing was noted at en dotracheal intubation. Lidocaine prevented coughing and a significant increase in IOP. Although significant increases in HR and MAP were obs erved in both groups (comparing preintubation and postintubation value s), these increases were significantly less in the L group compared wi th the C group. Conclusions: ln healthy premedicated children, aged 2 to 6 years, who are undergoing induction of anesthesia with halothane- N2O, 2 mg/kg of lidocaine given 90 seconds prior to laryngoscopy effec tively suppresses the cough reflex and increase in IOP secondary to en dotracheal intubation and attenuates increases in HR and MAP. (C) 1997 hv Elsevier Science Inc.