Efficacy of topical anesthesia with inhaled aerosolized lidocaine during tracheal intubation under guidance of fiberoptic bronchoscopy in cervical cord injury patients

Abstract

Objective To evaluate the efficacy of topical anesthesia with inhaled aerosolized lidocaine during tracheal intubation under the guidance of fiberoptic bronchoscopy (FOB) in patients with cervical cord injury complicated with high paraplegia. Methods Sixty-four patients with cervical cord injury complicated with high paraplegia were randomly divided into 2 groups ( n = 32 each): group Ⅰ aerosol inhalation and group Ⅱ spray and cricothyroid membrane puncture. In group Ⅰ aerosolized 2% lidocaine was inhaled. In group Ⅱ after the pharynx and larynx was sprayed with 2% lidocaine, cricothyroid membrane puncture was performed and then 2% lidocaine 2 ml was injected. Midazolam 0.01 mg/kg and fentanyl 1 μg/kg were injected iv in both groups 15 min before tracheal intubation guided by FOB. During tracheal intubation guided by FOB, the intubation condition was assessed, and MAP, HR, ECG and SpO2 were monitored. Results The satisfactory rate of intubation condition and success rate of intubation under the guidance of FOB were significantly higher, and the incidences of arrhythmia and bad memory lower in group Ⅰ than in group Ⅱ ( P ＜ 0.05). Conclusion The topical anesthesia with inhaled aerosolized 2% lidocaine is helpful for improving the FOB-guided tracheal intubation condition, and can reduce the occurrence of adverse effects in patients with cervical cord injury complicated with high paraplegia. Key words: Lidocaine; Administration, inhalation; Anesthesia, intratracheal; Bronchoscopy; Intubafion, intratracheal; Trauma, nervous system; Paraplegia