Intravenous Lidocaine After Tracheal Intubation Mitigates Bronchoconstriction in Patients With Asthma
Michael Adamzik,* Harald Groeben,* Ramin Farahani,* Nils Lehmann,† and Juergen Peters*
(Anesth Analg, 104:168-172, 2007)
*Klinik für Anästhesiologie und Intensivmedizin and †Institut für Medizinische Infomatik, Biometrie, and Epidemiologie, Universitätsklinikum Essen, Essen, Germany.
Although prophylactic intravenous lidocaine administration heightens the response to a variety of inhalational challenges, its effect on airway resistance after endotracheal intubation in asthma patients is not clear. The hypothesis was tested that intravenous lidocaine attenuates bronchoconstriction induced by intubation in patients with asthma. Thirty asthma patients (age [mean ± SD], 49.1 ± 15.6 years) undergoing intubation after standardized induction of anesthesia (etomidate, 0.3 mg/kg; fentanyl, 5 µg/kg; rocuronium, 0.6 mg/kg; 50% nitrous oxide) were studied. Airway resistance was measured immediately after intubation and 5, 10, and 15 minutes later. Five minutes after intubation, either lidocaine (2 mg/kg intravenously for 5 minutes, followed by 3 mg/kg per hour for 10 minutes) or saline was administered. Immediately after intubation, airway resistance averaged 23 ± 12 cm H2O per second per liter. It further increased (+38%) after administration of saline but later decreased (−26%) to less than the initial values after lidocaine. Intravenous lidocaine given after endotracheal intubation mitigates bronchoconstriction in asthma patients.