Abstract
To determine the effect of intravenous lidocaine on the intraocular pressure (lOP) response to laryngoscopy and intubation, twenty unpremedicated children, ages one to ten years were studied. After administration of either intravenous sterile water (control) (n = 10) or preservarive-free lidocaine (1.5 mg.kg-1 (n = 10), anaesthesia was induced with pancuronium (0.15 mg.kg-1 ), thiopentone (5 mg.kg-1), and atropine (0.02 mg.kg-1), and maintained with halothane, nitrous oxide and oxygen. The trachea was intubated one minute after administration of thiopentone, lOP (measured by applanation tonometry), heart rate, and systolic blood pressure were measured at the time of loss of the eyelid reflex (time 0), immediately after endotracheal intubation, and each minute thereafter for five minutes. In the control group, lOP increased (27 per cent) significantly after intubation (p < 0.05), whereas in the lidocaine group, 1OP did not increase (9.8 per cen) significantly after intubation. 1OP decreased below lime 0 values within three minutes after loss of the eyelid reflex in the lidocaine group (p < 0.05). At each measurement (except time 0), lOP was significantly greater in the control group than in the lidocaine group (p < 0.05). Heart rate and systolic blood pressure did not increase significantly in either group after intubation. We conclude that intravenous lidocaine (1.5 mg.kg-1 ) significantly attenuates the lOP response to laryngoscopy and intubation in children anaesthetized with pancuronium, thiopentone, and atropine.
Résumé
Afin de déterminer l’effet de l’administration intraveineuse de lidocaïne sur ta pression intra-ocutaire (IOP) lots de la laryngoscopie et t’intubation, vingt enfants non-prémédiqués, âtgés de un à dix arts ont été étudiés. Après l’administration intraveineuse soit de l’eau stérile (contrôle)(n = 10), ou de lidocaïne sans préservatif ( 1.5 mg.kg01 ) (n = 10), l’anesthésie a été induite avec du pancuronium(0.15 mg.kg-1 ), thiopentone (5 mg.kg-1), et atropine (0.02 mg.kg-1 ). L’ anesthésie a été maintenue avec l’halothane, le protoxyde d’azote et l’oxygène. La trachée a été intubée après une minute de l’administration de thiopentone. lOP (mesurée par tonométrie), la fréquence cardiaque ainsi que la tension artérielle systolique ont été mesurées lors de la perte du réflexe ciliaire (temps 0), immédiatement après intubation endotrachéale et par la suite à chaque minute pour cinq minutes. Duns le groupe contrôle, l’IOP augmenta (27 pour cent) significativement apris intubation (p < 0.05), ators que duns le groupe lidoca;ne, I’IOP n’a pas augmenté(9.8 pour cent) significativement après l’intubation. L’IOP a diminué; en bus des valeurs obtenues au temps O en dedans de trois minutes après la disparition du riflexe ciliaire dans le groupe lidocaïne (p < 0.05). A chaque mesure (exceptd au temps 0), l’IOP était significativement plus grande dans le groupe contrôle que dans le groupe lidocaïne (p < 0.05). La fréqaence cardiaque ainsi que la tension artérielle systolique n’ont pus augmenté significativement dans aucun des groupes après intubation. On conclut que l’administration intraveineuse de lidocaïne (1.5 mg.kg-1) atténue significativement l’IOP en rdponse à la laryngoscopie et l’intubation chez les enfants anesthesias avec pancuronium, thiopentone et atropine.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
France NK. Anesthesia for pediatric ophthalmic surgery. In: Pediatric Anesthesia, pp 794–6, edited by Gregory GA, New York: Churchill Livingston, 1983.
Steward DJ. Ophthalmology for penetrating eye injuries. In: Manual of Pediatric Anesthesia, pp 135–7, 2nd Edition, New York: Churchill Livingston, 1985.
George R, Nuisingh A, Downing JW, et al. Non-depolarizing neuromuscular blockers and the eye. A study of intraocular pressure. Br J Anaesth 1979; 51:789–92.
Blackburn CL, Morgan M. Comparison of speed of onset of action of fazadinium, pancuronium, tubocurare and succinylcholine. Br J Anaesth 1978; 50:361–4.
Hey VMF, Relaxants for endotracheal intubation. A comparison of depolarizing and non-depolarizing neuromuscular blocking agents. Anaesthesia 1973, 28:32–6.
Lincoff WA, Ellis CN, Devoe AG, et al. The effect of succinylcholine on intraocular pressure. Am J Ophthal 1955; 40:501–10.
Schwartz H, DeRoetth Jr A. Effect of succinylcholine on intraocular pressure in human beings. Anesthesiology 1958; 19:112–3.
Craythorne NWB, Rottenstein MS, Dripps RD. The effect of succinylcholine on intraocular pressure in adults, infants and children during general anaesthesia. Anesthesiology 1960; 21:59–63.
Wynands JE, Crowell DE. lntraocular tension in association with succinylcholine and endotracheal intubation: a preliminary report. Can Anaesth Soc J 1960; 7:39–43.
Smith RB, Leano N. lntraocular pressure following pancuronium. Can Anaesth Soc J 1973; 20:742–6.
Litwiller RW, DiFazio CA, Rushia EL. Pancuronium and intraocular pressure. Anesthesiology 1975; 42:750–2.
Patenaude BL, Robblee JA, Gardner Watson, A. The value of pancuronium in prolonged intraocular operations. Can J Ophthal 1977; 12:265–7.
Al-Abrak MH, Samuel JR. Effects of general anaesthesia on the intraocular pressure in man. Comparison of tubocurarine and pancuronium with nitrous oxide and oxygen. Br J Ophthal 1974; 58:806–10.
Lerman J, Kiskis AA. Effects of high-dose pancuronium and light anaesthesia on intraocular pressure in children. Anesthesiology 1984; 61:S434.
Brown EM, Krishnaprasad D, Smiler BG. Pancuronium for rapid induction technique for tracheal intubation. Can Anaesth Soc J 1979; 26:489–91.
Himes Jr RS, DiFazio CA, Burney RG. Effects of lidocaine on anesthetic requirements for N2O and halothame. Anesthesiology 1977; 47:437–40.
Poulton TJ, James FM III. Cough suppression by lidocaine. Anesthesiology 1979; 50:470–2.
Bedford RF, Persing JA, Pobereskin L, Butler A. Lidoeaine or thiopental for rapid control of intracranial hypertension? Anesth Analg 1980; 59:435–7.
Bedford RF. Winn HR, Tyson G, et al. Lidocaine prevents increased ICP after endotraeheal intubation. In Intrueranial pressure IV, pp. 95–8, edited by Shulman K, Marmarou A, Miller JD,et al. New York: Springer Verlag, 1980.
Abou-Madi MN, Keszler H,Yacoub JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Can Anaesth Soc J 1977; 24:12–19.
Perkins ES. Hand-held applanation tonometer. Br J Ophthal 1965; 49:591–3.
Lund I, Stovner J. Dose-response curves for tubocurarine, alcuronium, andpancuronium. Acta Anaesthesiol Scand Suppl 1970; 37:238–43.
Glantz SA. Primer of Biostatistics, pp. 87–8, New York; McGraw-Hill, 1981.
Zar JH. Biostadstical analysis, pp. 151, 163, New Jersey; Prentice-Hall Inc, 1974.
Smith RB, Babinski M, Leano N. The effect of lidocaine on succinylcholine produced rise in intraocular pressure. Can Anaesth SocJ 1979; 26:432–3.
Pandey K, Badola RP, Kumar S. Time course of intraocular hypertension produced by suxamethonium. Br J Anaesth 1972; 44:191–5.
Samuel JR, Beaugié A. Effect of carbon dioxide on the intraocular pressure in man during general anaesthesia. Br J Ophthal 1974; 58:62–7.
Rosen DA, Johnston VC. Ocular pressure patterns in the valsalva manoeuver. Arch Ophthal 1959; 62:810–816.
Stoelting RK. The hemodynamic effects of pancuronium and d-tubocurarine in anaesthetized patients. Anesthesiology 1972; 36:612–15.
Boos JC, Dunning AJ. Effects of lidocaine on impulse formation and conduction defects in man. Am Heart J 1975; 89:686–99.
Covino BG. Systemic toxicity of local anesthetic agents. Anesth Analg 1978; 57:387–8.
McWhirter WB, Schmidt FH, Frederickson EL, SteMhaus JE. Cardiovascular effects of controlled lidocaine overdosage in dogs anesthetized with nitrous oxide. Anesthesiology 1973; 39: 398–404.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lerman, J., Kiskis, A.A. Lidocaine attenuates the intraocular pressure response to rapid intubation in children. Can Anaesth Soc J 32, 339–345 (1985). https://doi.org/10.1007/BF03011337
Issue Date:
DOI: https://doi.org/10.1007/BF03011337