Intravenous lidocaine in high blood pressure and tachycardia prevention in intubated adult patients asa I and II under general anesthesia

Abstract

Introduction: laryngoscopy and endotracheal intubation (OTI) predispose to cardio-cerebral complications because of catecholamine release. Lidocaine, economic and widely available, has a controversial protective effect in low doses (< 1.5 mg/k body weight). It raises its effect in attenuating the increase in heart rate and blood pressure during these procedures by increasing the dose to 2 mg/k., taking advantage of its wide therapeutic window. Objective: to compare the hemodynamic changes during the IOT when applying lidocaine 1.5 mg/k vs 2 mg/k. Materials and methods: a randomized double-blind clinical trial with 30 patients in each group (alpha error = 0.05 and study power of 80%). The control group received lidocaine 1.5 mg/k, and the study group 2 mg/k during anesthetic induction. All patients received propofol, fentanyl and rocuronium. It was measured the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) at baseline, during IOT and every minute until 5 min. It was analyzed in epi-info 3.2.1. Results: there was less hemodynamic changes in lidocaine group 2 mg/k, with no statistically significant differences for all outcomes: FC (74.6 vs. 75.7, p = 0.75), SBP (119.7 vs. 120.3, p = 0.78), TAM (85.7 vs. 87.1, p = 0.72) and DBP (68.7 vs. 68.8, p = 0.72). Conclusions: there were neither clinical hemodynamic nor statistically significant differences during orotracheal intubation in ASA I and II patients taken to surgery under general anesthesia using lidocaine 2 mg/k vs 1.5 mg/k.