Topical larynx lidocaine Spraying reduces cardiovascular stress response caused by suspension laryngoscopic surgery

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Brazilian Journal of Otorhinolaryngology Pub Date : 2024-08-05 DOI:10.1016/j.bjorl.2024.101481

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Abstract

Objective

This study aimed to investigate the potential reduction of cardiovascular stress response caused by suspension laryngoscopic surgery through the application of lidocaine spray on the larynx and trachea.

Methods

A total of 68 patients scheduled for elective suspension laryngoscopic surgery were randomly assigned to either the lidocaine group (Group L, n = 34) or the control group (Group C, n = 33). In Group L, patients received a sprayed lidocaine dose of 2 mg/kg on the larynx and trachea after anesthesia induction, prior to intubation. In Group C, equal volumes of saline solution were administered. MAP and HR were recorded at various time points: before anesthesia (T0), 1-minute after intubation (T1), 1 and 3 min after suspension laryngoscopy (T2 and T3), at the end of the operation (T4), and at 1, 5, and 30 min after extubation (T5, T6, and T7). Arterial blood glucose, epinephrine, and norepinephrine levels were measured at T0, T2, T5, and T7. The occurrence of severe cough and sore throat at T6 and T7 after extubation was compared between the two groups.

Results

At T0 and T1, there were no statistically significant differences in mean arterial pressures, heart rate, and blood catecholamine levels between the two groups. However, from T2 to T7, the blood pressure and heart rate in Group L were lower compared to Group C, with significant differences observed at T2‒T6 (p < 0.05). Group L also showed less elevation in blood glucose at T2, T5, and T7 (p < 0.05). The changes in epinephrine and norepinephrine levels between the two groups were statistically significant at T2 and T5 (p < 0.05).

Conclusions

Administering lidocaine spray on the larynx and trachea during intubation for suspension laryngoscopic surgery can effectively alleviate the stress response.

Level 1 evidence

Patients in this study are randomly assigned to the treatment or control group and are followed prospectively.

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局部喉部利多卡因喷雾剂可降低悬吊喉镜手术引起的心血管应激反应

本研究旨在探讨通过在喉部和气管喷洒利多卡因来减少悬吊喉镜手术引起的心血管应激反应的可能性。方法将68名计划进行择期悬吊喉镜手术的患者随机分配到利多卡因组（L组，n = 34）或对照组（C组，n = 33）。L组患者在麻醉诱导后插管前，在喉部和气管上喷洒剂量为2毫克/千克的利多卡因。C 组患者接受等量生理盐水。在麻醉前（T0）、插管后 1 分钟（T1）、悬吊喉镜检查后 1 和 3 分钟（T2 和 T3）、手术结束时（T4）以及拔管后 1、5 和 30 分钟（T5、T6 和 T7）的不同时间点记录血压和心率。在 T0、T2、T5 和 T7 测量动脉血葡萄糖、肾上腺素和去甲肾上腺素水平。结果在 T0 和 T1，两组患者的平均动脉压、心率和血液中儿茶酚胺水平的差异无统计学意义。然而，从 T2 到 T7，与 C 组相比，L 组的血压和心率较低，在 T2-T6 观察到显著差异（p <0.05）。L 组在 T2、T5 和 T7 的血糖升高也较少（p < 0.05）。结论在悬吊喉镜手术插管过程中在喉部和气管喷洒利多卡因可有效缓解应激反应。1级证据本研究中的患者被随机分配到治疗组或对照组，并接受前瞻性随访。

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来源期刊

Brazilian Journal of Otorhinolaryngology OTORHINOLARYNGOLOGY-

CiteScore

3.00

自引率

0.00%

发文量

205

审稿时长

4-8 weeks

期刊介绍： Brazilian Journal of Otorhinolaryngology publishes original contributions in otolaryngology and the associated areas (cranio-maxillo-facial surgery and phoniatrics). The aim of this journal is the national and international divulgation of the scientific production interesting to the otolaryngology, as well as the discussion, in editorials, of subjects of scientific, academic and professional relevance. The Brazilian Journal of Otorhinolaryngology is born from the Revista Brasileira de Otorrinolaringologia, of which it is the English version, created and indexed by MEDLINE in 2005. It is the official scientific publication of the Brazilian Association of Otolaryngology and Cervicofacial Surgery. Its abbreviated title is Braz J Otorhinolaryngol., which should be used in bibliographies, footnotes and bibliographical references and strips.