Lidocaine Spray, Intubation, Robotic Surgery
Conditions
Brief summary
Endotracheal intubation is a respiratory management technique used during general anesthesia. It is essential for certain surgical procedures as it ensures a secure airway for the patient. However, during the placement of the endotracheal tube, the passage of the tube through the vocal cords can cause pain stimulation, leading to an increase in heart rate and blood pressure. Lidocaine reversibly blocks the conduction of nerve impulses along nerve fibers by preventing the movement of sodium ions across the nerve membrane. Topical application of lidocaine near the vocal cords before endotracheal tube placement may be a way to reduce the surgical pleth index and changes in vital signs (heart rate, blood pressure) caused by excessive endotracheal tube stimulation. This study aims to investigate the benefit of topical spraying of lidocaine on the vocal cords before endotracheal tube placement during routine da Vinci surgery. The primary outcomes were the pharmacological effects of spraying either lidocaine or normal saline (control group) on the vocal cords. These included: post-intubation hypertension (defined as an increase in systolic blood pressure of more than 20% from baseline), changes in mean arterial pressure before and after intubation, and objective pain indices such as the Surgical Pleth Index. Secondary outcomes included post-intubation hypotension (defined as mean arterial pressure less than 70 mmHg), as well as postoperative complaints and severity of sore throat, pain on swallowing, and hoarseness.
Interventions
During general anesthesia, the anesthesiologist administers 1.5cc of lidocaine spraying on the vocal cords using Terumo SurfloTM I.V. Catheter 20G before intubation.
DRUGNormal Saline (0.9% NaCl)
During general anesthesia, the anesthesiologist administers 1.5cc of normal saline spraying on the vocal cords using Terumo SurfloTM I.V. Catheter 20G before intubation.
Sponsors
Kaohsiung Medical University Chung-Ho Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 69 Years
Healthy volunteers
No
Inclusion criteria
* ASA classification I\ III * aged 18\ 69 y/o * BMI 18\ 35 kg/m2 * scheduled for elective robotic surgery under general anesthesia
Exclusion criteria
* Allergy or contraindication to lidocaine
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| post-intubation hypertension | From enrollment to the end of surgery | defined as an increase in systolic blood pressure of more than 20% from baseline |
| changes in mean arterial pressure before and after intubation | From enrollment to the end of surgery | — |
| objective pain indices (Surgical Pleth Index) | From enrollment to the end of surgery | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| post-intubation hypotension | From enrollment to postoperative day 1 | defined as mean arterial pressure less than 70 mmHg |
| hoarseness | From enrollment to postoperative day 1 | During patients' stay in post-anesthetic care unit and our postoperative follow-up visiting at postoperative day 1, we will check the patients if they have any complaint of hoarseness. |
| postoperative sore throat | From enrollment to postoperative day 1 | During patients' stay in post-anesthetic care unit and our postoperative follow-up visiting at postoperative day 1, we will check the patients if they have any complaint of postoperative sore throat. |
| pain on swallowing | From enrollment to postoperative day 1 | During patients' stay in post-anesthetic care unit and our postoperative follow-up visiting at postoperative day 1, we will check the patients if they have any complaint of pain on swallowing. |
Countries
Taiwan
Contacts
Primary ContactYuh-Shyan Wu, MD
Backup ContactI-Cheng Lu, PhD
Outcome results
None listed