Summary
The efficacy of intravenously administered lidocaine 0.75 mg/kg and 1.5 mg/kg to protect against cardiovascular reactions associated with laryngoscopy and tracheal intubation was studied in two comparable groups of ten patients and compared with a similar control group of ten patients given only saline. Following laryngoscopy and tracheal intubation, the 1.5 mg/kg dose afforded complete protection against cardiac arrhythmias of all types. The smaller dose was ineffectual in this respect. While the larger dose caused borderline protection against hypertension and tachycardia, the smaller dose prevented only the rise in systolic blood pressure. Possible mechanisms to account for these observations are discussed. These include a direct myocardial depressant effect, a central stimulant effect, a peripheral vasodilating effect and finally an effect on synaptic transmission.
Résumé
Les effets ďune dose i.v. de 0.75 mg/kg de Lidocaïne et ceux ďune dose de 1.5 mg/kg ont été étudiés chez deux groupes comparables de dix patients chacun, et ont été comparés à ceux observés dans un troisième groupe de dix patients ayant reçu une solution saline.
Lorsqu’elle est administrée avant la laryngoscopie et ľintubation trachéale, la Lidocaïne à la dose de 1.5 mg/kg protège complètement contre tous les types ďarythmies. Une dose de 0.75 mg/kg est inefficace.
La Lidocaïne à la dose de 1.5 mg/kg assure de plus une protection contre ľhypertension et la tachycardie, alors qu’à 0.75 mg/kg elle prévient seulement ľélévation de la tension systolique. Les causes possibles de cette action peuvent être une dépression directe du myocarde, ou une vasodilatation périphérique, ou un effet stimulant central, ou, finalement, un effet sur la transmission synaptique.
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Adi, M.N.AM., Keszler, H. & Yacoub, J.M. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Canad. Anaesth. Soc. J. 24, 12–19 (1977). https://doi.org/10.1007/BF03006808
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DOI: https://doi.org/10.1007/BF03006808