• Sunil Rajan, Nitu Puthenveettil, Krishnakumar Thankappan, and Jerry Paul.
• Department of Anaesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
• Anesth Essays Res. 2013 Jan 1; 7 (1): 110-5.

AimThe purpose of this study was to evaluate the efficacy of transtracheal lidocaine injection to reduce the anesthetic requirements in patients who underwent brachial plexus surgery under general anesthesia.Settings And DesignThis was a prospective randomized controlled study conducted in 40 consecutive adult patients.Materials And MethodsThe patients were randomly allotted to two groups of 20 patients each. Group A patients received a transtracheal injection of 4 ml of 2% lidocaine before induction of anesthesia and group B patients did not receive it. The two groups were compared in terms of intraoperative propofol requirements and hemodynamic parameters.Statistical Analysis UsedStatistical analysis was done using Student's t-test for independent samples.ResultsThe propofol requirements were significantly less in group A in terms of the number of intraoperative events requiring propofol bolus at various time intervals in 3 h duration (4 vs. 77), the number of patients requiring propofol bolus injections (2 vs. 20), propofol infusion (0 vs. 20), and total propofol requirement (6 vs. 377 mg). After induction, patients in group B showed a statistically significant high heart rate, systolic blood pressure, and mean arterial pressure.ConclusionThe present study showed that the group of patients who received transtracheal block with lidocaine had a reduction in the requirement of the induction agent, propofol, and were more stable hemodynamically in the intraoperative period compared to those patients who did not receive transtracheal lidocaine. We conclude that transtracheal injection of lidocaine performed just prior to induction of general anesthesia is an effective alternative to intraoperative propofol infusion when long-acting muscle relaxants are to be avoided.

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