DOES NEBULIZED LIDOCAINE ATTENUATE HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND OROTRACHEAL INTUBATION? A systematic review.

Abstract

Background: Laryngoscopy and orotracheal intubation often trigger physiological responses such as tachycardia, hypertension, and arrhythmias, primarily due to sympathetic stimulation. These reactions can pose significant risks for patients with cardiovascular conditions. Objective: To evaluate the efficacy of nebulized lidocaine as a premedication in preventing hemodynamic responses to orotracheal intubation in adult patients undergoing elective surgery and general anesthesia. Methods: We conducted electronic searches in PubMed, Embase, and Cochrane Central, identifying studies that included patients aged 16 and older. Included studies were randomized controlled trials comparing nebulized lidocaine to controls or other interventions, focusing on mean arterial pressure (MAP), heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Results: A total of 10 studies involving 765 patients met our criteria. The majority of these studies demonstrated that nebulized lidocaine significantly reduced increases in MAP, HR, SBP, and DBP compared to control groups and intravenous lidocaine. However, outcomes varied when compared to other agents like magnesium sulfate and fentanyl. Conclusions: Nebulized lidocaine appears to be an effective method for attenuating hemodynamic responses to laryngoscopy and orotracheal intubation in adult patients undergoing elective surgeries.