Efficacy of lidocaine intraveously combined with remifentanil on endotracheal intubation without muscle relaxants during laryngeal microscopic surgery

Abstract

Objective To investigate the clinical effects of intravenous injection of lidocaine combined with remifentanil on tracheal intubation without muscle relaxants by for laryngeal microscopic surgery.Methods 75 ASA Ⅰ-Ⅱ patients undergoing laryngeal microscopic surgery for tracheal intubation without muscle relaxants were randomly divided into Group Ⅰ (conventional induction),group Ⅱ (remifentanil)and group Ⅲ (lidocaine combined with remifentanil).These intubating conditions (VibyMogenson),extubation time and awakening quality (movement activity score of the MAAS) were recorded.Mean arterial pressure (MAP) and heart rate (HR) were also recorded T1(before induction) and T2(immediately before) and T3(after intubation).Blood glucose(Glu) and cortisol(Cor) were tested at T2 and T4(extubation).Results There was no significant difference in the scores of VibyMogenson(P＞0.05).MAP[(64±7) mm Hg](1 mm Hg=0.133 kPa) and HR[(61±6) bpm] in Group Ⅱ were significantly lower than those in Group Ⅰ [(73±8) mm Hg,(68±8) bpm],Ⅲ[(71±8) mm Hg,(67±7) bpm] at T2 (P＜0.05).Extubation time [(6.4±2.4) min]and MAAS score[(4.1±1.3)] at T4 in group Ⅲ were significantly shorter than those in group Ⅰ [(15.6±3.7) min and (6.6±2.7)],Ⅱ [(7.9±2.6) min and (5.5±2.3)] (P＜0.05).Glu [(5.7± 1.4) mmol/L] and Cor [(0.77±0.68) mmol/L] in group Ⅲ were significantly lower than those in group Ⅰ [(7.7±1.7),(0.98±0.54) mmol/L],Ⅱ [(7.5±1.6),(0.97±0.49) mmol/L] at T4(P＜0.05).Conclusions Tracheal intubation without muscle relaxants by intravenous injection of lidocaine combined with remifentanil for laryngeal microscopic surgery was safe and efficient. Key words: Lidocaine ; Remifentanil; Tracheal intubation; Laryngeal microscopic surgery