Abstract: Objectives: The aim of this study to investigate whether lidocaine nebulizer attenuates airway-circulatory
reflexes during induction and emergence, tube tolerance, nasal pack tolerance and reduced total dose of opioid
analgesia Patients and methods: This prospective, randomized, placebo controlled, double blind clinical trial was
conducted on 60 patients scheduled for nasal surgery under general anesthesia were randomly allocated into two
equal groups: Group A (Study group) was given Lidocaine 2% (2 mg/kg) in 5 ml saline was added to a standard
nebulizer with a full face mask attached with O2 flow at 3 L/min., then the patient was asked to inhale the local
anesthetic vapor deeply for 15 minutes and Group B (control group) was given5 ml saline 0.9% was added to a
standard nebulizer with a full face mask attached with O2 flow at 3L/min. over 15 minutes. Hemodynamic
parameters, tube tolerance, nasal pack tolerance, amount of bleeding, time to first analgesic request, total Morphine
consumption over the 1st 24 hours and postoperative pain score were recorded. Results: Patient’s tolerance to
endotracheal tube in the study group showed a highly significant increase in numbers of patients in grade 0 and
highly significant decrease in numbers in grades 1 and 2 in comparison with the control group. The study group
showed better tolerance to nasal pack than the control group. The amount of blood collected was significantly higher
in the study than the control group. Time to 1st analgesic request was highly significant longer in study group than
control group. Total morphine dose given to patients in the 1st 24 hours postoperatively was significantly higher in
the control group than the study group. Conclusion: Lidocaine nebulizer technique is simple effective way to
suppress the cough and hyper dynamic reflex responses with minimal side effect. |
