Intravenous and topic laryngeal administration of pethidine or lidocaine for prevention of haemodynamic reaction after laryngoscopy and tracheal intubation

Abstract

As pethidine is the only opioid with local anaesthetic properties, the aim of the study was to evaluate the haemodynamic response during laryngoscopy and tracheal intubation consecutive to topic anaesthesia of the laryngotracheal mucosa with 0.5% pethidine solution versus 4.0% lidocaine solution and after intravenous administration of 1.5 mg/kg pethidine or 1.5 mg/kg lidocaine. The study was performed in 64 patients ASA I ­ II, divided into 4 groups: group I (control), n=16 patients: topic 5 ml lidocaine 4% and i.v. 10 ml saline; group II, n=16 patients: topic 1.5 mg/kg pethidine in 5 ml saline and i.v. 10 ml saline; group III, n=16 patients: topic 5 ml saline and i.v. 1.5 mg/kg lidocaine in 10 ml saline; group IV, n=16 patients: topic 5 ml saline and i.v. 1.5 mg/kg pethidine in 10ml saline. The following haemodynamic parameters were measured: SBP, DBP, MBP and the heart rate at 1 min. interval during 5 min. after tracheal intubation. The results confirmed the efficacy of lidocaine in reduction of the haemodynamic response after laryngoscopy and tracheal intubation, both after topic and intravenous administration. The topic application of pethidine did not abolish the haemodynamic response and the i.v. administration of the drug was followed by erythematous skin reactions.

Key words: haemodynamic response, tracheal intubation, lidocaine, pethidine

Jurnalul Român de Anestezie Terapie intensivă 2002 Vol.9 Nr.1, 21-26

Administrarea intravenoasă sau topică laringiană de petidină sau xilină pentru cuparea reacţiei hemodinamice după laringoscopie şi intubaţie traheală