Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation

Purpose: In order to examine the efficacy of tracheal lidocaine (TL) for at tenuation of the cardiovascular responses to endotracheal intubation (EI), we compared the cardiovascular responses to TL alone and EI with TIL, with those to EI without TL. Methods: Seventy-five patients (ASA I-II) were studied. Anesthesia was indu ced with fentanyl 2 mug.kg(-1) iv, thiamylal 5 mg.kg(-1) iv and sevoflurane 1.0% in oxygen. Vecuronium 0.12 mg.kg(-1) was used to facilitate EI. In Gr oup A (n=25), three minutes after induction, EI was performed. In Group B ( n=25), three minutes after induction, the patients received TIL (4% lidocai ne, 4 mL). This was followed by immediate EI. In Group C (n=25), El was per formed two minutes after TL. Heart rate, arterial blood pressure and rate- pressure product (RPP) were measured from one minute before induction until five minutes after EI. Results: The changes of RPP caused by TL alone in Group C (TL; + 34.6 +/- 2 9.0%, mean +/- SD) were significantly (P < 0.01) less than those caused by EI without TL in Group A (+ 77.3 +/- 42.6%). EI after TL in Group C did not cause significant changes in RPP (+5.4 +/- 15.2%). There were no significa nt differences between Groups A and B (+58.3 +/- 36.6%). Conclusion: We conclude that the cardiovascular responses to TL alone are h alf as great as those to EI without TL, and that TL is effective for attenu ation of the cardiovascular responses to EI. EI should be performed more th an two minutes after TL.