Efficacy of IV lidocaine in Prevention of Laryngospasm in Pediatric Patients Undergoing ENT Surgical Procedures

Abstract

Laryngospasm is a well-known problem of the upper airway typically occurring during the peri-operative period most commonly during intubation or extubation. Risk factors should be managed pre-operatively in order to prevent laryngospasm occurrence, together with preventative drugs such as lidocaine, magnesium sulphate, propofol and laryngeal aspiration before extubation. Lidocaine is Local anesthetic and as known to inhibit airway reflexes. Pediatric laryngospasm is most commonly occurring phenomenon due to multiple factors. . A five months randomized placebo-controlled trial was conducted to study the effectiveness of intravenous lidocaine in the prevention of post extubation laryngospasm in children, following cleft palate surgeries. Children of age one month to sixteen years were randomly assigned into two groups. Group P placebo (saline) and Group L (Lidocaine), 1.5 mg/kg. A sample size of 126 with n = 63 in each group was selected. The anaesthetic procedure was standardized. At the end of the procedure, three minutes after reversal, the study drug, that is, intravenous lidocaine (1.5 mg/kg) or placebo (saline) was administered and two minutes later the child was extubated. Following extubation for 10 minutes, the haemodynamic parameters, that is, pulse, blood pressure, oxygen saturation, severity of coughing, and laryngospasm were noted. Significant alterations in haemodynamics and oxygen saturation were noted for 10 minutes, following extubation. Hence, intravenous lidocaine 1.5 mg/kg was effective in the prevention of post extubation laryngospasm in children undergoing pediatric surgeries.