Is intravenous lidocaine an effective adjuvant for endotracheal intubation in children undergoing induction of anesthesia with halothane-nitrous oxide?

Abstract

Study Objective: To evaluate the efficacy of intravenous (IV) lidocaine in suppressing the cough reflex and increases in intraocular pressure (IOP), heart rate (HR), and mean arterial pressure (MAP) elicited by endotracheal intubation. Design: Prospective, randomized, placebo-controlled, blinded study. Patients: 60 ASA physical status I premedicated children aged 2 to 6 years undergoing induction of anesthesia with halothane-nitrous oxide (N 2O) for surgery to correct strabismus. Interventions: Patients were randomly divided into two groups of 30 each. The control group (C) received saline and the treatment group (L) received 2 mg/kg IV lidocaine 90 seconds prior to endotracheal intubation. Measurements and Main Results: Awake HR and MAP; IOP, HR, and MAP 45 seconds prior to endotracheal intubation, immediately after endotracheal intubation, and 1 minute later, were recorded. Coughing was noted at endotracheal intubation. Lidocaine prevented coughing and a significant increase in IOP. Although significant increases in HR and MAP were observed in both groups (comparing preintubation and postintubation values), these increases were significantly less in the L group compared with the C group. Conclusions: In healthy premedicated children, aged 2 to 6 years, who are undergoing induction of anesthesia with halothane-N 2O, 2 mg/kg of lidocaine given 90 seconds prior to laryngoscopy effectively suppresses the cough reflex and increase in IOP secondary to endotracheal intubation and attenuates increases in HR and MAP.