• Deok Hee Lee and Sang-Jin Park.
• Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
• Korean J Anesthesiol. 2011 Jun 1;60(6):422-7.

BackgroundIt is well known that suspension laryngoscopy (SL) produces marked hemodynamic changes. Coughing during extubation sometimes causes adverse clinical problems. We investigated whether 10% lidocaine spray could attenuate hemodynamic stress responses due to SL and reduce coughing incidence during extubation.MethodsSixty patients undergoing SL were randomly divided into two groups and intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine, sprayed onto laryngeal and intratracheal sites 2 min prior to intubation (10% lidocaine group). Mean arterial pressure (MAP) and heart rates (HR) during SL and coughing incidence during extubation were recorded.ResultsMAP at 2.5 and 5 min (P < 0.05) and HR at 2.5 min after SL (P < 0.01) were greater in the control group than in the 10% lidocaine group. The number of coughs decreased in the 10% lidocaine group compared to the control group during pre- (6.8 ± 3.2 vs 10.3 ± 4.4, P < 0.01) and post-extubation period of 5 min (4.0 ± 2.3 vs 6.2 ± 4.2, P < 0.05) and during the entire study period (10.8 ± 3.9 vs 16.5 ± 5.6, P < 0.001).ConclusionsPreoperative laryngeal and intratracheal spraying with 1.5 mg/kg of 10% lidocaine spray is effective for attenuation of arterial pressure increase to SL and suppression of coughing during extubation.

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