Effect of lidocaine and small dose of remifentanil on tracheal extubation period of children with general anaesthesia

Abstract

Objective To compare the effects of lidocaine and small dose remifentanil infusion in children on recovery profiles such as coughing and cardiovascular responses after general anaesthesia. Methods Sixty children underwent adenotonsillectomy under general anaesthesia using total intravenous anaesthesia (propofol and remifentanil) were randomly divided into lidocaine group(group L, n=32) and remifentanil group(group R, n=28). At the end of surgery, propofol was ceased, and the remifentanil infusion was stopped in group L and maintained in group R at an effect-site concentration of 2.0 ng/ml until extubation. At the same time, lidocaine 1.5 mg/kg was intravenously administered in group L. The incidence and severity of cough, haemodynamic parameters, and recovery profiles were evaluated during the emergence. Results There was no significant difference in sex ratio, age, weight, eye opening time, extubation time, nausea, and visual analogue scale. Increases in mean arterial pressure and heart rate occurred during extubation in the two groups compared with baseline values. The mean arterial pressure and heart rate were significantly lower in the group R than those in the group L during the emergence period(P<0.05). The incidence of cough during the emergence was significantly higher in group L than that in group R, and so was the grade of cough(P<0.05). Conclusions Maintaining small-dose remifentanil infusion can reduce haemodynamic changes and coughing associated with tracheal extubation, without delaying recovery from anaesthesia. Key words: Lidocaine; Remifentanil; Children; General anaesthesia; Tracheal extubation