A Clinical Observation Of Lidocaine Used In Tracheal Intubation

Objective: To compare the different effects of using lidocaine jelly and lidocaine injection on suppress the stress reaction and prevent the complications of tracheal intubation.Methods: 200 patients(ASA I-II, Mallampati 1-2 ) scheduled for elective gynecologic surgeries under general orotracheal anesthesia were randomly devided to 5 groups: lidocaine jelly(group J, n=40), lidocaine spray to the glottis and trachea(group L, n=40), lidocaine spray to the oralis pharynx (group P, n=40), lidocaine spray to the oralis pharynx and jelly(group B, n=40) and the saline group(group C, n=40). All the patients were 18-60 years old and had neither pharyngitis nor other diseases of the respiratory and the cardiovascular system. Their SBP, DBP, MAP, HR and SpO2 were monitored at the different time points below: before anesthesia induction (baseline, T0); after anesthesia induction (T1) and 0,1,3,5 minutes after tracheal intubation (T2-T5). The incidence of bucking and the restlessness score were recorded. The incidence of sore throat and hoarseness were also recored between 24-30 hours after operation and the degree of pharyngalgia were evaluated by the VAS.Results: (1) There was no statistical significance compared with the ages, weight and the intubation time amony each groups (P>0.05).(2) Compare with T0, The SBP, DBP, MAP and HR were below the baseline after intubation but up to baseline at T3 of group C (P>0.05), and these of group J were decreased at T3 (P<0.05); the SBP and HR of gruopL were decreased(P<0.05) (3) The SBP, DBP, MAP of group J at T3,T4,T5 were all decreased compared with group C(P<0.05), the same as in group P after T2 (P<0.05).(4) The incidence of sore throat was 20%(8/40) in group J, lower than group C(χ~2=5.698,P<0.05); the VAS score of group J and group L were also less than group C(P<0.05).(5) In group J, the incidence of hoarseness was 17.5%(7/40), while the bucking and restlessness was 15%(6/40) and 20%(8/40) respectively, which were decreased as compared with group C(P<0.05). ( 6) It has significant differences for the incidence of hoarseness, bucking and restlessness between group L and group C(P<0.05).Conclusion: 1.There was a significant inhibiting effect to the response of cardiovascular system while the lidocaine spray was applied to the glottis and trachea before intubation. 2. The external application of lidocaine jelly to the tracheal tube can obviously alleviate the incidence of pharyngalgia and hoarseness after operation.