Application of Intravenous Lidocaine in Patients Undergoing Fiberoptic Bronchoscopy with General Anesthesia_West China Medical Journal

Authors：

 ZHANGJun , MUJie , ZHANGXiang ,  WANGRu-rong

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

WANGRu-rong, Email: 576950028@qq.com

Keywords：

Lidocaine; Fiberoptic bronchoscopy; General anesthesia induction; Laryngeal mask airway

DOI：

10.7507/1002-0179.20150419

Video：

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Objective To evaluate if intravenous lidocaine can reduce the stress response induced by fiberoptic bronchoscopy in patients under general anesthesia. Methods Sixty patients undergoing fiberoptic bronchoscopy under unconsciousness between November 2013 and July 2014 were randomly divided into two groups: lidocaine group (n=30) and control group (n=30). Patients in the lidocaine group received an intravenous injection of lidocaine for 1 mg/kg during induction and then continuous intravenous infusion of 2% lidocaine with a dose of 3 mg/(kg·h). The same volume of saline was given to patients of the control group in the same way. Laryngeal mask airway was placed after anesthesia induction. Variables of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse oxygen saturation were observed and recorded at five time points: before induction, immediately after induction, immediately after laryngeal mask airway placement, fiberoptic bronchoscopy across tracheal carina and before leaving examination room. Complications including cough reflex, toxicity reaction of local anesthetics, and injection pain were also observed. Results The examination was successfully completed in all patients. Blood pressure and heart rate increased in all patients when fiberoptic bronchoscopy got across tracheal carina. There were no statistically significant differences in the two groups (P>0.05). Patients in the two groups had no statistic difference in tinnitus and numbness of tongue (P>0.05). Compared with the control group, patients in the lidocaine group had lower incidence of injection pain (P<0.05). Conclusion Intravenous lidocaine cannot suppress stress response induced by fiberoptic bronchoscopy effectively.

Citation： ZHANGJun, MUJie, ZHANGXiang, WANGRu-rong. Application of Intravenous Lidocaine in Patients Undergoing Fiberoptic Bronchoscopy with General Anesthesia. West China Medical Journal, 2015, 30(8): 1465-1468. doi: 10.7507/1002-0179.20150419 Copy

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2.	Neidhart G, Kovács AF, Bremerich DH, et al. Remifentanil-propofol for bronchoscopic fiber optic intubation under capnographic control[J]. Anaesthesist, 2000, 49(6):523-526.
3.	Tam S, Chung F, Campbell M. Intravenous lidocaine:optimal time of injection before tracheal intubation[J]. Anesth Analg, 1987, 66(10):1036-1038.
4.	雷勇靜, 陳傳英, 劉曉彬, 等. 無痛纖維支氣管鏡檢查的麻醉進展[J]. 中國醫師進修雜志, 2014, 37(12):74-76.
5.	Ferrà M, Vila P, Escudero A, et al. Sevoflurane in airway management using fibrobronchoscopy:apropos of 2 difficult orotracheal intubation cases[J]. Rev Esp Anestesiol Reanim, 1999, 46(6):264-266.
6.	Yamasaki H, Takahashi K, Yamamoto S. Efficacy of endotracheal lidocaine administration with continuous infusion of remifentanil for attenuating tube-induced coughing during emergence from total intravenous anesthesia[J]. J Anesth, 2013, 27(6):822-886.
7.	Hamaya Y, Dohi S. Differences in cardiovascular response to airway stimulation at different sites and blockade of the responses by lidocaine[J]. Anesthesiology, 2000, 93(1):95-103.
8.	黃亮, 蔣學華, 張勤, 等. 生理藥動學模型研究利多卡因靜脈給藥的體內過程[J]. 中國藥學雜志, 2006, 41(8):585-589.
9.	Vivancos GG, Klamt JG, Garcia L. Effects of 2 mg·kg-1 of intravenous lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to orotracheal intubation[J]. Rev Bras Anestesiol, 2011, 61(1):1-12.
10.	王保國. 氣管插管反應及其預防[J]. 臨床麻醉學雜志, 1989, 5(2):109-112.
11.	Xu Z, Liu F, Yue Y, et al. C50 for propofol-remifentanil target-controlled infusion and bispectral index at loss of consciousness and response to painful stimulus in Chinese patients:a multicenter clinical trial[J]. Anesth Analg, 2009, 108(2):478-483.
12.	Dahaba AA, Zhong T, Lu HS, et al. Geographic differences in the target-controlled infusion estimated concentration of propofol:bispectral index response curves[J]. Can J Anaesth, 2011, 58(4):364-370.
13.	周期, 符少川, 馬乃全. 利多卡因的臨床應用現狀[J]. 中國老年學雜志, 2007, 27(18):1832-1835.
14.	Yakaitis RW, Blitt CD, Angiulo JP. End-tidal halothane concentration for endotracheal intubation[J]. Anesthesiology, 1977, 47(4):386-388.
15.	Meftahuzzaman SM, Islam MM, Ireen ST. Comparison of efficacy of labetalol and fentanyl for attenuating reflex responses to laryngoscopy and intubation[J]. Mymensingh Med J, 2014, 23(2):242-248.
16.	Singh S, Laing EF, Owiredu WK. Comparison of esmolol and lidocaine for attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation in a Ghanaian population[J]. Anesth Essavs Res, 2013, 7(1):83-88.

1. Stolz D, Chhajed PN, Leuppi J, et al. Nebulized lidocaine for flexible bronchoscopy:a randomized, double-blind, placebo-controlled trial[J]. Chest, 2005, 128(3):1756-1760.
2. Neidhart G, Kovács AF, Bremerich DH, et al. Remifentanil-propofol for bronchoscopic fiber optic intubation under capnographic control[J]. Anaesthesist, 2000, 49(6):523-526.
3. Tam S, Chung F, Campbell M. Intravenous lidocaine:optimal time of injection before tracheal intubation[J]. Anesth Analg, 1987, 66(10):1036-1038.
4. 雷勇靜, 陳傳英, 劉曉彬, 等. 無痛纖維支氣管鏡檢查的麻醉進展[J]. 中國醫師進修雜志, 2014, 37(12):74-76.
5. Ferrà M, Vila P, Escudero A, et al. Sevoflurane in airway management using fibrobronchoscopy:apropos of 2 difficult orotracheal intubation cases[J]. Rev Esp Anestesiol Reanim, 1999, 46(6):264-266.
6. Yamasaki H, Takahashi K, Yamamoto S. Efficacy of endotracheal lidocaine administration with continuous infusion of remifentanil for attenuating tube-induced coughing during emergence from total intravenous anesthesia[J]. J Anesth, 2013, 27(6):822-886.
7. Hamaya Y, Dohi S. Differences in cardiovascular response to airway stimulation at different sites and blockade of the responses by lidocaine[J]. Anesthesiology, 2000, 93(1):95-103.
8. 黃亮, 蔣學華, 張勤, 等. 生理藥動學模型研究利多卡因靜脈給藥的體內過程[J]. 中國藥學雜志, 2006, 41(8):585-589.
9. Vivancos GG, Klamt JG, Garcia L. Effects of 2 mg·kg-1 of intravenous lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to orotracheal intubation[J]. Rev Bras Anestesiol, 2011, 61(1):1-12.
10. 王保國. 氣管插管反應及其預防[J]. 臨床麻醉學雜志, 1989, 5(2):109-112.
11. Xu Z, Liu F, Yue Y, et al. C50 for propofol-remifentanil target-controlled infusion and bispectral index at loss of consciousness and response to painful stimulus in Chinese patients:a multicenter clinical trial[J]. Anesth Analg, 2009, 108(2):478-483.
12. Dahaba AA, Zhong T, Lu HS, et al. Geographic differences in the target-controlled infusion estimated concentration of propofol:bispectral index response curves[J]. Can J Anaesth, 2011, 58(4):364-370.
13. 周期, 符少川, 馬乃全. 利多卡因的臨床應用現狀[J]. 中國老年學雜志, 2007, 27(18):1832-1835.
14. Yakaitis RW, Blitt CD, Angiulo JP. End-tidal halothane concentration for endotracheal intubation[J]. Anesthesiology, 1977, 47(4):386-388.
15. Meftahuzzaman SM, Islam MM, Ireen ST. Comparison of efficacy of labetalol and fentanyl for attenuating reflex responses to laryngoscopy and intubation[J]. Mymensingh Med J, 2014, 23(2):242-248.
16. Singh S, Laing EF, Owiredu WK. Comparison of esmolol and lidocaine for attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation in a Ghanaian population[J]. Anesth Essavs Res, 2013, 7(1):83-88.

West China Medical Journal

Application of Intravenous Lidocaine in Patients Undergoing Fiberoptic Bronchoscopy with General Anesthesia

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