Abstract
BackgroundNebulized lidocaine reduced stress response for endotracheal intubation. However, the impact of novel lidocaine aerosol inhalation for intubation by ultrasonic atomizer was unclear. Hence, we designed aerosol inhalation of lidocaine by ultrasonic atomizer, to seek whether the dosage of sufentanil for intubation could be less or not.MethodsIntravenous injection of sufentanil started at 0.5 μg/kg, and sufentanil dosage was increased/decreased (step-size 0.05 μg/kg for sufentanil) using Dixon’s up and down method. The observation was terminated after 8 reflexes.ResultsThe EC50 and EC95 of sufentanil with lidocaine by ultrasonic atomizer for intubation were found to be 0.232 μg/kg (95% CI: 0.187–0.270 μg/kg) and 0.447 μg/kg (95% CI: 0.364–0.703 μg/kg). 55.88% out of 34 patients showed hemodynamic index change < 20% of baseline during intubation.ConclusionAerosol inhalation of lidocaine by ultrasonic atomizer reduced the dosage of sufentanil for endotracheal intubation. Lidocaine inhalation by ultrasonic atomizer for airway anesthesia with minimal dosage of sufentanil could be recommended, particularly in patients who need more stable hemodynamic changes or spontaneous respiration.Trial registrationChinese Registry of Central Trial, ChiCTR-IOR-17014198.Registered 28 December 2017.
Highlights
Nebulized lidocaine reduced stress response for endotracheal intubation
In this study, we aimed to investigate the sufentanil Concentration for 50% of maximal effect (EC50) for endotracheal intubation with inhalation lidocaine by ultrasonic atomizer
The EC50 and EC95 of sufentanil with aerosol inhalation of lidocaine for endotracheal intubation were found to be 0.232 μg/kg and 0.447 μg/kg
Summary
Nebulized lidocaine reduced stress response for endotracheal intubation. The impact of novel lidocaine aerosol inhalation for intubation by ultrasonic atomizer was unclear. We designed aerosol inhalation of lidocaine by ultrasonic atomizer, to seek whether the dosage of sufentanil for intubation could be less or not. Endotracheal intubation could not be carried out with no stress response under opioid-free anesthesia. Topical lidocaine surface anesthesia combined with minimal opioid was recommended in awake tracheal intubation [5]. The lidocaine inhalation for airway anesthesia by ultrasonic atomizer was easy and valid. Evidence showed inhalation of lidocaine attenuated the response to airway irritation with lower plasma concentrations [9]
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