Comparison of intravenous and transtracheal lidocaine on hemodynamic changes in patients with hypertension following tracheal intubation: A double blind clinical trial

Background: Hemodynamic changes following intubation can be reduced by lidocaine at the time of induction of anesthesia and during laryngoscopy to prevent complications such as myocardial ischemia, infarction and brain damage. The aim of this study was to compare the effects of intravenous lidocaine and transtracheal lidocaine on hemodynamic changes in patients with hypertension under medical treatment following tracheal intubation. Materials and methods: In this prospective double-blind randomized clinical study, patients aged 40-70 years with hypertension who were candidates for general anesthetic surgery were randomly divided into three groups: A (intravenous lidocaine), B (transtracheal lidocaine) and C (placebo). Blood pressure and heart rate were record at 30 s after induction of anesthesia, 30 s after intubation and 3, 6 and 9 min after intubation. Results: The results showed that the mean systolic blood pressure varied significantly between 3 groups at 30 s after induction (group A: 127.08 +/- 10.08, group B: 134 +/- 9.77 and group C: 123 +/- 1.55 mmHg) (P = 0.007) and 30 s after intubation (group A: 154.42 +/- 15.75, group B: 142.58 +/- 8.63, group C: 158 +/- 17.37 mmHg) (P = 0.001). The mean diastolic blood pressure was significantly different between 3 groups in 30 s after intubation (group A: 93.23 +/- 13.7, group B: 87.92 +/- 4.22 and group C: 98.09 +/- 9.29 mmHg) (P = 0.003). The mean heart rate was significantly different between 3 groups in 30 s after intubation (group A: 81.65 +/- 8.06, group B: 74.65 +/- 6.22 and group C: 82.5 +/- 7.16 bit/minutes) (P < 0.001). Conclusion: Our results showed that use of lidocaine in hypertensive patients following tracheal intubation can results in a more stable systolic and diastolic blood pressure as well as heart rate. It should be noted that the use of lidocaine for the presence or absence of cardiac dysrhythmias showed no difference among the study groups. (C) 2019 Elsevier Ltd. All rights reserved.