Advertisement

Effects of intravenous and topical laryngeal lidocaine on heart rate, mean arterial pressure and cough response to endotracheal intubation in dogs

  • Kate R Thompson
    Correspondence
    Correspondence: Kate R Thompson, Department of Veterinary Anaesthesia, Small Animal Teaching Hospital, University of Liverpool, Neston CH64 7TE, UK
    Affiliations
    Department of Veterinary Anaesthesia, Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK
    Search for articles by this author
  • Eva Rioja
    Affiliations
    Department of Veterinary Anaesthesia, Small Animal Teaching Hospital, University of Liverpool, Liverpool, UK
    Search for articles by this author

      Abstract

      Objective

      To compare the effects of intravenous (IV) and topical laryngeal lidocaine on heart rate (HR), mean arterial pressure (MAP) and cough response to endotracheal intubation (ETI) in dogs.

      Study design

      Prospective, randomized, blinded clinical study.

      Animals

      Forty-two client-owned dogs (American Society of Anesthesiologists class I and II status) undergoing elective orthopaedic surgery.

      Methods

      Dogs were randomized to three groups. Dogs in group SALIV received 0.1 mL kg−1 IV saline. Dogs in group LIDIV received 2 mg kg−1 IV 2% lidocaine. Dogs in group LIDTA received 0.4 mg kg−1 topically sprayed laryngeal 2% lidocaine. All dogs were premedicated with methadone (0.2 mg kg−1 IV). After 30 minutes, IV propofol was administered to abolish the lateral palpebral reflex and produce jaw relaxation. The allocated treatment was then administered and, after 30 seconds, further propofol was administered to abolish the medial palpebral reflex and facilitate ETI. HR and MAP were measured at four time-points using cardiac auscultation and automated oscillometry, respectively. The cough response at ETI was recorded. One-way anova and post hoc Tukey adjustment were used to analyse parametric data. The Kruskal-Wallis test was used to analyse non-parametric data. Odds ratios were calculated for the cough response. A p-value of =0.05 was considered to indicate statistical significance.

      Results

      In response to ETI, changes in MAP differed significantly between groups. In SALIV, MAP increased (4 ± 6 mmHg), whereas it decreased in LIDIV (6 ± 13 mmHg) (p= 0.013) and LIDTA (7 ± 11 mmHg) (p= 0.003). Dogs in SALIV were almost 10 times more likely to cough than dogs in LIDIV (odds ratio 9.75, 95% confidence interval 0.98–96.60; p = 0.05).

      Conclusions and clinical relevance

      In propofol-anaesthetized dogs, IV and topical laryngeal lidocaine attenuated the pressor response to ETI, whereas IV lidocaine reduced the cough response.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Veterinary Anaesthesia and Analgesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bülow K
        • Nielson TG
        • Lund J
        The effect of topical lignocaine on intubating conditions after propofol–alfentanil induction.
        Acta Anaesthesiol Scand. 1996; 40: 752-756
        • Chou DT
        • Wang SC
        Studies on the localization of central cough mechanism: site of action of antitussive drugs.
        J Pharmacol Exp Ther. 1975; 194: 499-505
        • Credie RG
        • Neto FLT
        • Ferreira TH
        • et al.
        Effects of methadone on the minimum alveolar concentration of isoflurane in dogs.
        Vet Anaesth Analg. 2010; 37: 240-249
        • Edwards ND
        • Alford AM
        • Dobson PM
        Myocardial ischaemia during tracheal intubation and extubation.
        Br J Anaesth. 1994; 73: 537-539
        • Erb TO
        • von Ungern-Sternberg BS
        • Keller K
        • et al.
        The effect of intravenous lidocaine on laryngeal and respiratory reflex response in anaesthetized children.
        Anaesthesia. 2013; 68: 13-20
        • Forbes AM
        • Dally FG
        Acute hypertension during induction of anaesthesia and endotracheal intubation in normotensive man.
        Br J Anaesth. 1970; 42: 618-624
        • Fox EJ
        • Sklar GS
        • Hill CH
        • et al.
        Complications related to the pressor response to endotracheal intubation.
        Anesthesiology. 1977; 47: 524-525
        • Garofalo NA
        • Teixeira Neto FJ
        • Alvaides RK
        • et al.
        Agreement between direct, oscillometric and Doppler ultrasound blood pressures using three different cuff positions in anesthetized dogs.
        Vet Anaesth Analg. 2012; 39: 324-334
      1. Principles of sedation, analgesia and premedication.
        in: Hall LW Clarke KW Trim CM Veterinary Anaesthesia. 10th edn. WB Saunders, UK2001: 75-112
        • Hamill JF
        • Bedford RF
        • Weaver DC
        • et al.
        Lidocaine before endotracheal intubation: intravenous or laryngotracheal?.
        Anesthesiology. 1981; 55: 578-581
        • Hamilton ND
        • Hegarty M
        • Calder A
        • et al.
        Does topical lidocaine before tracheal intubation attenuate the airway responses in children? An observational audit.
        Paediatr Anaesth. 2012; 22: 345-350
        • Holzchuh MP
        • Fantone DT
        • Cortopassi SRG
        Study of intravenous anaesthesia in dogs with use of propofol effects on the arterial pressure and heart rate.
        Vet Anaesth Analg. 1991; 18: 155-157
        • Jakobsen C-J
        • Ahlburg P
        • Holdgård HO
        • et al.
        Comparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia.
        Acta Anaesthesiol Scand. 1991; 35: 238-241
        • Jolliffe CT
        • Leece EA
        • Adams V
        • et al.
        Effect of intravenous lidocaine on heart rate, systolic arterial blood pressure and cough responses to endotracheal intubation in propofol-anaesthetized dogs.
        Vet Anaesth Analg. 2007; 34: 322-330
        • Kautto U-M
        • Heinonen J
        Attenuation of circulatory response to laryngoscopy and tracheal intubation: a comparison of two methods of topical anaesthesia.
        Acta Anaesthesiol Scand. 1982; 26: 599-602
        • King BD
        • Harris LC
        • Greifenstein FE
        • et al.
        Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anesthesia.
        Anesthesiology. 1951; 12: 556
        • McCoy EP
        • Mirakhur RK
        • McCloskey BV
        A comparison of the stress response to laryngoscopy.
        Anaesthesia. 1995; 50: 943-946
        • Menegheti TM
        • Wagatsuma JT
        • Pacheco AD
        • et al.
        Electrocardiographic evaluation of the degree of sedation and the isolated use of methadone in healthy dogs.
        Vet Anaesth Analg. 2014; 41: 97-104
        • Mihara T
        • Uchimoto K
        • Morita S
        • et al.
        The efficacy of lidocaine to prevent laryngospasm in children: a systematic review and meta-analysis.
        Anaesthesia. 2014; 69: 1388-1396
        • Miller CD
        • Warren SJ
        IV lignocaine fails to attenuate the cardiovascular response to laryngoscopy and tracheal intubation.
        Br J Anaesth. 1990; 65: 216-219
        • Monteiro ER
        • Figueroa CDN
        • Choma JC
        • et al.
        Effects of methadone, alone or in combination with acepromazine or xylazine, on sedation and physiologic values in dogs.
        Vet Anaesth Analg. 2008; 35: 519-527
        • Mostafa SM
        • Murthy BVS
        • Barrett PJ
        • et al.
        Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia on the pressor response to direct laryngoscopy and intubation.
        Eur J Anaesthesiol. 1999; 16: 7-10
        • Pathak RM
        • Slater SS
        • Ping RP
        Effects of alfentanil and lidocaine on the hemodynamic responses to laryngoscopy and tracheal intubation.
        J Clin Anesth. 1990; 2: 81-85
        • Robinson R
        • Clancy M
        In patients with head injury undergoing rapid sequence intubation, does pretreatment with IV lignocaine/lidocaine lead to improve neurological outcome? A review of literature.
        Emerg Med J. 2001; 18: 453-457
        • Shapiro HM
        • Wyte SR
        • Hams AB
        • et al.
        Acute intraoperative intracranial hypertension in neurosurgical patients.
        Anesthesiology. 1972; 37: 399
        • Shribman AJ
        • Smith G
        • Achola J
        Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation.
        Br J Anaesth. 1987; 59: 295-299
        • Singh H
        • Vichitvejpaisal P
        • Gaines GY
        Comparative effects of lidocaine, esmolol, and nitroglycerin in modifying the hemodynamic response to laryngoscopy and intubation.
        J Clin Anesth. 1995; 7: 5-8
        • Sklar BZ
        • Lurie S
        • Ezri T
        • et al.
        Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation.
        J Clin Anesth. 1992; 4: 382-385
        • Steinhaus JE
        • Gaskin I
        A study of intravenous lidocaine as a suppressant of the cough reflex.
        Anesthesiology. 1963; 24: 285-290
        • Terada H
        • Ohta S
        • Nishikawa T
        • et al.
        The effect of intravenous or subarachnoid lidocaine on glutamate accumulation during transient forebrain ischaemia in rats.
        Anaesth Analg. 1999; 89: 957-961
        • Tomori Z
        • Widdicombe JG
        Muscular, bronchomotor and cardiovascular reflexes elicited by mechanical stimulation of the respiratory tract.
        J Physiol. 1969; 200: 25
        • Webb AI
        • Pablo LS
        Local anesthetics.
        in: Riviere JE Papich MG Veterinary Pharmacology and Therapeutics. 9th edn. Wiley-Blackwell, USA2009: 393
        • Wilson IG
        • Meiklejohn BH
        • Smith G
        Intravenous lignocaine and sympathoadrenal responses to laryngoscopy and intubation.
        Anaesthesia. 1991; 46: 177-180
        • Yukioka H
        • Hayashi M
        • Terai T
        • et al.
        Intravenous lidocaine as a suppressant of coughing during tracheal intubation in elderly patients.
        Anesth Analg. 1993; 77: 309-312