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Direct laryngoscopy and endotracheal intubation procedure stimulate the sympathetic nervous system, causing catecholamine release into the circulation and consequently hemodynamic changes.There are many studies showing that lidocaine is used intravenously to suppress the sympathetic response to laryngoscopy and endotracheal intubation. Nebulized lidocaine is often used to provide upper airway local anesthesia in fiberoptic guided awake intubation.
In this study, the researchers aimed to compare the results of using intravenous lidocaine and nebulized lidocaine to suppress the hemodynamic response caused by laryngoscopy and endotracheal intubation retrospectively.
Researchers' hypothesis; Nebulized lidocaine administration is more effective than intravenous lidocaine administration in suppressing the hemodynamic response due to laryngoscopy and endotracheal intubation in patients under general anesthesia.
2% lidocaine drug to suppress the hemodynamic response due to laryngoscopy and endotracheal intubation; patients administered intravenously will be evaluated in one group, and patients administered inhaled through a nebulizer will be evaluated in another group.
Nebulized lidocaine in the researchers' clinic; it is administered by adding 2% lidocaine + physiological saline to a nebulizer and inhaling for 3-5 minutes in the presence of 4-6 liters/minute of oxygen.
Preoperative examination forms and intraoperative follow-up forms of the patients included in the study will be examined by the researchers. The dose of lidocaine applied and the method of administration will be recorded. In addition, the agents used in anesthesia induction (fentanyl, propofol, rocuronium bromide, etc.) and the hemodynamic changes of the patients (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure,oxygen saturation) will be recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intravenous lidocaine | Patients who received lidocaine intravenously before induction of anesthesia will be considered in this group. |
| |
| Nebulized lidocaine | Patients who received lidocaine by inhalation with a nebulizer before induction of anesthesia will be considered in this group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nebulized Lidocaine | Drug | Before induction of anesthesia, 2% lidocaine + physiological saline was added to a nebulizer and inhaled for 3-5 minutes in the presence of 4-6 liters/minute of oxygen. |
| Measure | Description | Time Frame |
|---|---|---|
| Heart Rate | Patients were monitored with a three-lead ECG in the operating room and their heart rates were recorded as beats per minute. (.../min) | Just before induction of anesthesia |
| Heart Rate | Patients were monitored with a three-lead ECG in the operating room and their heart rates were recorded as beats per minute. (.../min) | Immediately after induction of anesthesia |
| Heart Rate | Patients were monitored with a three-lead ECG in the operating room and their heart rates were recorded as beats per minute. (.../min) | 5 minutes and 10 minutes after direct laryngoscopy and endotracheal intubation |
| Blood Pressure | The patients were monitored in the operating room by wearing a noninvasive blood pressure cuff and measurements were taken at 5-minute intervals. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in mmHg. | Just before induction of anesthesia |
| Blood Pressure | The patients were monitored in the operating room by wearing a noninvasive blood pressure cuff and measurements were taken at 5-minute intervals. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in mmHg. | Immediately after induction of anesthesia |
| Blood Pressure | The patients were monitored in the operating room by wearing a noninvasive blood pressure cuff and measurements were taken at 5-minute intervals. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in mmHg. |
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Inclusion Criteria:
Exclusion Criteria:
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80 patients over the age of 18 and under the age of 80 who underwent surgery under general anesthesia in the operating room will be included in the study.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Derince Training and Research Hospital | Kocaeli | 41900 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15815458 | Result | Baronia AK, Singh PK, Maheshwari A, Jain VK, Mittal P, Pant KC. Inhaled lidocaine for prevention of hemodynamic changes in laryngoscopy and intubation. J Neurosurg Anesthesiol. 1992 Jul;4(3):154-9. doi: 10.1097/00008506-199207000-00002. | |
| 1389192 | Result | Sklar BZ, Lurie S, Ezri T, Krichelli D, Savir I, Soroker D. Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1992 Sep-Oct;4(5):382-5. doi: 10.1016/0952-8180(92)90160-3. |
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| ID | Term |
|---|---|
| D008012 | Lidocaine |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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| Iv Lidocaine | Drug | Intravenous %2 lidocaine was administered before induction of anesthesia. |
|
| 5 minutes and 10 minutes after direct laryngoscopy and endotracheal intubation |
| Oxygen Saturation | The patients were monitored with a pulse oximetry device in the operating room and their oxygen saturation % (spO2) was recorded. | Just before induction of anesthesia |
| Oxygen Saturation | The patients were monitored with a pulse oximetry device in the operating room and their oxygen saturation % (spO2) was recorded. | Immediately after induction of anesthesia |
| Oxygen Saturation | The patients were monitored with a pulse oximetry device in the operating room and their oxygen saturation % (spO2) was recorded. | 5 minutes and 10 minutes after direct laryngoscopy and endotracheal intubation |
| Aniline Compounds |
| D000588 | Amines |