Effect of Intra-cuff 4% Lidocaine on the Dosage of Nitroglycerine Required to Maintain Hemodynamic Stability before and after Extubation in Patients with Hypertension

Jung, Wol Seon; Lee, Kyung Cheon; Kim, Hong Soon; Choi, Jung Ju; Lee, Dongchul

Clinical Research

General Article

Anesthesia and Pain Medicine 2006;1(2):133-138.
Published online October 30, 2006.

Effect of Intra-cuff 4% Lidocaine on the Dosage of Nitroglycerine Required to Maintain Hemodynamic Stability before and after Extubation in Patients with Hypertension

Wol Seon Jung, Kyung Cheon Lee, Hong Soon Kim, Jung Ju Choi, Dongchul Lee

Department of Anesthesiology and Pain Medicine, Gil Hospital, Gachon University, Incheon, Korea. suasdad@nate.com

Abstract

BACKGROUND
Elevated blood pressures during emergence from general anesthesia in patients with hypertension often result in undesirable complications such as myocardial ischemia, intracranial hemorrhages. The aim of this study was to assess the effect of intracuff 4% lidocaine on the dosage of nitroglycerine required to maintain the stable blood pressure during peri-extubation period in patients with hypertension. METHODS: Forty-nine patients scheduled for elective surgery were randomly allocated to group 1 and 2. We filled endotracheal tube's cuff with normal saline for group 1 and with 4% lidocaine for group 2. Blood pressures and heart rates were recorded before operation, during emergence, and after extubation. Nitroglycerine infusion was adjusted to maintain systolic blood pressure below 150 mmHg. Total infused dosages of nitroglycerine were recorded during operation and after stop of inhalational anesthetics for comparison of both groups' hemodynamic stability. RESULTS: Mean infused volume (microg/kg/min) of nitroglycerine during peri-extubation period was less in the group 2 than group 1. CONCLUSIONS: Intra-cuff 4% lidocaine in patients with hypertension during emergence from general anesthesia reduces the nitroglycerine dosage required to maintain hemodynamic stability.

Key Words: hypertension, intra-cuff, lidocaine, nitroglycerine