Lidocaine in the Prevention of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation

Retrospective Investigation of the Effects of Different Uses of Lidocaine in the Prevention of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation

Direct laryngoscopy and endotracheal intubation procedure stimulate the sympathetic nervous system, causing catecholamine release into the circulation and consequently hemodynamic changes.There are many studies showing that lidocaine is used intravenously to suppress the sympathetic response to laryngoscopy and endotracheal intubation. Nebulized lidocaine is often used to provide upper airway local anesthesia in fiberoptic guided awake intubation.

In this study, the researchers aimed to compare the results of using intravenous lidocaine and nebulized lidocaine to suppress the hemodynamic response caused by laryngoscopy and endotracheal intubation retrospectively.

Researchers' hypothesis; Nebulized lidocaine administration is more effective than intravenous lidocaine administration in suppressing the hemodynamic response due to laryngoscopy and endotracheal intubation in patients under general anesthesia.

Study Overview

• Status: Recruiting
• Conditions: Lidocaine
• Intervention / Treatment: Drug: Iv Lidocaine; Drug: Nebulized Lidocaine

Detailed Description

2% lidocaine drug to suppress the hemodynamic response due to laryngoscopy and endotracheal intubation; patients administered intravenously will be evaluated in one group, and patients administered inhaled through a nebulizer will be evaluated in another group.

Nebulized lidocaine in the researchers' clinic; it is administered by adding 2% lidocaine + physiological saline to a nebulizer and inhaling for 3-5 minutes in the presence of 4-6 liters/minute of oxygen.

Preoperative examination forms and intraoperative follow-up forms of the patients included in the study will be examined by the researchers. The dose of lidocaine applied and the method of administration will be recorded. In addition, the agents used in anesthesia induction (fentanyl, propofol, rocuronium bromide, etc.) and the hemodynamic changes of the patients (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure,oxygen saturation) will be recorded.

• Study Type: Observational
• Enrollment (Estimated): 80

Contacts and Locations

• Study Contact: Name: Emine Atlı; Phone Number: +905388442699; Email: dr.emineatli@gmail.com
• Study Contact Backup: Name: Mehmet Yılmaz; Phone Number: +905052174432; Email: drmyilmaz33@gmail.com

Study Locations

• Turkey
  • Kocaeli, Turkey, 41900
    • Recruiting
    • Derince Training and Research Hospital
    • Contact: Mehmet Yılmaz; Phone Number: +905052174432; Email: drmyilmaz33@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

80 patients over the age of 18 and under the age of 80 who underwent surgery under general anesthesia in the operating room will be included in the study.

Description

Inclusion Criteria:

• Patients over the age of 18 and under the age of 80 who underwent surgery under general anesthesia

Exclusion Criteria:

• Patients under the age of 18 and over the age of 80
• Patients who are not operated under general anesthesia

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Intravenous lidocaine; Patients who received lidocaine intravenously before induction of anesthesia will be considered in this group.	Drug: Iv Lidocaine; Intravenous %2 lidocaine was administered before induction of anesthesia.
Nebulized lidocaine; Patients who received lidocaine by inhalation with a nebulizer before induction of anesthesia will be considered in this group.	Drug: Nebulized Lidocaine; Before induction of anesthesia, 2% lidocaine + physiological saline was added to a nebulizer and inhaled for 3-5 minutes in the presence of 4-6 liters/minute of oxygen.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Heart Rate	Patients were monitored with a three-lead ECG in the operating room and their heart rates were recorded as beats per minute. (.../min)	Just before induction of anesthesia
Heart Rate	Patients were monitored with a three-lead ECG in the operating room and their heart rates were recorded as beats per minute. (.../min)	Immediately after induction of anesthesia
Heart Rate	Patients were monitored with a three-lead ECG in the operating room and their heart rates were recorded as beats per minute. (.../min)	5 minutes and 10 minutes after direct laryngoscopy and endotracheal intubation
Oxygen Saturation	The patients were monitored with a pulse oximetry device in the operating room and their oxygen saturation % (spO2) was recorded.	Just before induction of anesthesia
Oxygen Saturation	The patients were monitored with a pulse oximetry device in the operating room and their oxygen saturation % (spO2) was recorded.	Immediately after induction of anesthesia
Oxygen Saturation	The patients were monitored with a pulse oximetry device in the operating room and their oxygen saturation % (spO2) was recorded.	5 minutes and 10 minutes after direct laryngoscopy and endotracheal intubation
Blood Pressure	The patients were monitored in the operating room by wearing a noninvasive blood pressure cuff and measurements were taken at 5-minute intervals. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in mmHg.	Just before induction of anesthesia
Blood Pressure	The patients were monitored in the operating room by wearing a noninvasive blood pressure cuff and measurements were taken at 5-minute intervals. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in mmHg.	Immediately after induction of anesthesia
Blood Pressure	The patients were monitored in the operating room by wearing a noninvasive blood pressure cuff and measurements were taken at 5-minute intervals. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in mmHg.	5 minutes and 10 minutes after direct laryngoscopy and endotracheal intubation

Collaborators and Investigators

• Sponsor: Derince Training and Research Hospital

Publications and helpful links

General Publications

• Baronia AK, Singh PK, Maheshwari A, Jain VK, Mittal P, Pant KC. Inhaled lidocaine for prevention of hemodynamic changes in laryngoscopy and intubation. J Neurosurg Anesthesiol. 1992 Jul;4(3):154-9. doi: 10.1097/00008506-199207000-00002.
• Sklar BZ, Lurie S, Ezri T, Krichelli D, Savir I, Soroker D. Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1992 Sep-Oct;4(5):382-5. doi: 10.1016/0952-8180(92)90160-3.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2023
• Primary Completion (Estimated): June 1, 2024
• Study Completion (Estimated): July 1, 2024

Study Registration Dates

• First Submitted: September 4, 2023
• First Submitted That Met QC Criteria: October 24, 2023
• First Posted (Actual): October 30, 2023

Study Record Updates

• Last Update Posted (Actual): April 24, 2024
• Last Update Submitted That Met QC Criteria: April 23, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: General anaesthesia; Lidocaine; Intubation
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Arrhythmia Agents; Central Nervous System Depressants; Peripheral Nervous System Agents; Sensory System Agents; Anesthetics; Membrane Transport Modulators; Anesthetics, Local; Voltage-Gated Sodium Channel Blockers; Sodium Channel Blockers; Lidocaine
• Other Study ID Numbers: DerinceTRH-EAtli-001

Drug and device information, study documents

• Studies a U.S. FDA-regulated device product: No