Intravenous lignocaine as pretreatment for intubation of patients with acute severe head injury

Abstract

Intravenous lignocaine at a dose of 1.5–2.0 mg/kg is frequently included in intubation protocols for patients with acute severe head injury. This literature review attempts to provide an evidence base for this. A Medline search and review of all relevant articles post-1966 was undertaken. There is evidence that lignocaine has a beneficial effect on intracranial and intraocular pressures. Neuroprotection is demonstrated in some animal models. There is, however, no evidence that lignocaine improves outcome. This article recommends using lignocaine in pre-intubation for patients where a rise in intraocular pressure is a concern (e.g. penetrating eye injury), but cannot, on evidence alone, justify its inclusion in head injury protocols.