Topical larynx lidocaine Spraying reduces cardiovascular stress response caused by suspension laryngoscopic surgery

• Published in: Brazilian journal of otorhinolaryngology 2024-11, Vol.90 (6), p.101481, Article 101481
• Main Authors: Huan, Liu, Wenhao, Bu, Xiangdong, Chen, Zhilin, Wu
• Format: Article
• Language: English
• Subjects: Administration, Topical; Adult; Anesthetics, Local - administration & dosage; Blood Pressure - drug effects; Epinephrine; Female; Heart Rate - drug effects; Hemodynamics; Humans; Laryngoscopic; Laryngoscopy; Larynx - drug effects; Larynx - surgery; Lidocaine; Lidocaine - administration & dosage; Male; Middle Aged; Norepinephrine; Original; Stress, Physiological - drug effects
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2024.101481

•Suspension laryngoscopic surgery leads to cardiovascular stress response.•Sprayed lidocaine on the surgical area can reduce the stress response.•Adrenaline and norepinephrine were less elevated in lidocaine spraying group. This study aimed to investigate the potential reduction of cardiovascular stress response caused by suspension laryngoscopic surgery through the application of lidocaine spray on the larynx and trachea. A total of 68 patients scheduled for elective suspension laryngoscopic surgery were randomly assigned to either the lidocaine group (Group L, n = 34) or the control group (Group C, n = 33). In Group L, patients received a sprayed lidocaine dose of 2 mg/kg on the larynx and trachea after anesthesia induction, prior to intubation. In Group C, equal volumes of saline solution were administered. MAP and HR were recorded at various time points: before anesthesia (T0), 1-minute after intubation (T1), 1 and 3 min after suspension laryngoscopy (T2 and T3), at the end of the operation (T4), and at 1, 5, and 30 min after extubation (T5, T6, and T7). Arterial blood glucose, epinephrine, and norepinephrine levels were measured at T0, T2, T5, and T7. The occurrence of severe cough and sore throat at T6 and T7 after extubation was compared between the two groups. At T0 and T1, there were no statistically significant differences in mean arterial pressures, heart rate, and blood catecholamine levels between the two groups. However, from T2 to T7, the blood pressure and heart rate in Group L were lower compared to Group C, with significant differences observed at T2‒T6 (p