Comparison of intravenous and topical lidocaine effect on the hemodynamic response of endotracheal ıntubation

BACGROUND: In this study, during induction of anesthesia, depending on laryngoscopy and endotracheal intubation, we intended to compare the efficiencies of IV and topical lidocaine in preventing increases in the number of developed hypertension and heart rate as a result of sympathetic adrenergic response.METHODS: ASA 1-3 group whose elective operation was planned, was conducted on the 120 patients who did not have contraindications for general anesthesia, accepted the treatment we will bring, were chosen as randomly, and were male and female between 18 and 65 ages, and was done randomly. By opening intravenous with 20 G cannula, perfusion of 10 ml / kg / h 0,9% NaCl was started to given all patients who were informed about method and whose approvals were received, at operating table.Electrocardiography (at D II derivation), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MAP), heart rate (HR) were monitored. At induction, IV propofol 2 mg/kg in seconds 45, 2 microg / kg fentanyl and IV vecuronyum bromide 0,1 mg / kg in 15 seconds were given. Patients were randomly divided into two study groups.Group I(n=60): After adequate muscle relaxation( 3 minutes then vecuronium injection) was supplied, 10% lidocaine (xylocain) sprey 3 puff was given with direct laryngoscopy.Group II(n=60): 1,5 mg / kg IV bolus of 2% lidocaine was applied in 30 seconds.Patients? ventilation was supplied with 100% O2 during induction. 3 minutes after induction, laryngoscopy and endotracheal intubation was performed by the same person. Maintenance of anesthesia in all groups was maintained with 50% (3L/minutes) O2 and sevoflurane 2-3%.Measurements in all groups, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MAP) and heart rate (HR) for baseline, after intubation at 1, 2, 4, 6, 8, and 10 minutes were recorded. After the postoperative PACU, the patients were questioned about sore throat and cough.RESULTS: Different groups of drugs was found that differed from each other in terms of heart rate. While it was observed values in real-time measurements of heart rate after intubation was low in Group II, it was high in Group I. Between-group comparisons, systolic and mean arterial blood pressure measurements, no statistically significant difference was observed. In terms of diastolic blood pressure measurements, Group I was found 50 minutes significantly higher than Group II(P<0.01), and Group II was found a 10 minutes statistically significantly lower than Group I(P<0.002). In postoperative first hour, according to Group I, sore throat and cough were significantly lower than Group II.CONCLUSİONS: In suppressing the hemodynamic response to intubation, IV lidocaine was more successful than topical lidocaine. In this study, none of the groups has been found effective in suppressing hemodynamic response to laryngoscopy and endotracheal intubation. Lidocaine spray was effective in reducing postoperative cough and sore throat.KEYWORDS: sore throat, the hemodynamic response to intubation, cough