The effect of different doses of intravenous lidocaine on rocuronium onset time and intubation conditions

AIM: In our study the effects of lidocaine with different doses given intravenously on the frequency of propofol and rocuronium injection pain, on hemodynamic response observed with laryngoscopy-intubation and on onset time of rocuronium were investigated.MATERIAL AND METHOD: 120 patients scheduled to undergo elective surgery under general anesthesia, who were in ASA I-II risk group and between the ages of, 18 to 65 years were included in the study. TOF monitorization was carried out for muscle relaxation and ASA standards were performed for cardiovascular monitoring. Patients were randomly allocated to four equal groups. Group I received saline (control), Group II received 0,5 mg kg-1 lidocaine, Group III 1,0 mg kg-1 received lidocaine and Group IV received 1,5 mg kg-1 lidocaine in 10 mL saline (i.v.) 1 minute before induction. After determining the side effects of lidocaine during this period, for induction 2 mg kg-1 propofol and 0.6 mg kg-1 rocuronium were administered. Injection pain due to induction drugs was evaluated with Arm Withdrawal Scale. For the effect of muscle relaxant TOF value was recorded every 15 seconds. When neuromuscular transmission was blocked 90 % (T10: time period until the effect of rocuronium starts) endotreacheal intubation was carried out. In addition, 100 % block development time (T0) was determined. The quality of endotracheal intubation was evaluated with `Intubation Evaluation Scale?. Anesthesia was maintained using 0.2 µg kg-1 min-1 remifentanil, 2 % sevoflurane, 2 L dk-1 oxygen and 4 L min-1 air mixture. Heart rates (HR) and mean arterial pressures (MAP) were recorded as control, before administration of saline or lidocaine, prior to induction and every 2 minute until 15 minutes after induction.RESULTS: Demographic data of the patients were similar. In Saline group both HR and MAP data showed a significant increase based on control values after intubation and this increase were also significant compared with lidocaine groups. (p<0.05). We have seen that lidocaine has reduced the HR at the induction and MAP after induction of anesthesia, but there?s no difference between lidocaine groups. In all lidocaine groups including the dose of 0,5 mg kg-1, it was established that injection pain was reduced, better laryngoscopy and intubation conditions were achieved and the frequency of side effects increased depending on the dose of lidocaine. Rocuronium onset time (T10) in groups were observed as: saline 107,43± 34.50, lidocaine 0,5 mg kg-1 97,90 ± 33,49, lidocaine 1,0 mg kg-1 184,87 ± 22,157 and lidocaine 1,5 mg kg-1 82,60±25,021 seconds.CONCLUSION: It was demonstrated that in general anesthesia even 0,5 mg kg-1 lidocaine administration has favorable effects on hemodynamic response, intubation and laryngoscopy conditions, onset time and injection pain of rocuronium.