Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

• Published in: Canadian journal of anesthesia Vol. 57; no. 8; pp. 745 - 750
• Main Authors: Schebesta, Karl, Güloglu, Elisabeth, Chiari, Astrid, Mayer, Nikolaus, Kimberger, Oliver
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-08-2010; Springer; Springer Nature B.V
• Subjects: Administration, Topical; Aging - physiology; Airway management; Anesthesia; Anesthesia Recovery Period; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology; Anesthetics, Local - administration & dosage; Anesthetics, Local - therapeutic use; Biological and medical sciences; Cardiology; Child; Child, Preschool; Critical Care Medicine; Double-Blind Method; Female; Gels; Humans; Infections; Intensive; Laryngeal Masks; Length of Stay; Lidocaine - administration & dosage; Lidocaine - therapeutic use; Lubricants & lubrication; Male; Medical personnel; Medical sciences; Medicine; Medicine & Public Health; Pain Medicine; Pediatrics; Pneumology/Respiratory System; Postoperative Complications - epidemiology; Reports of Original Investigations; Respiratory Tract Infections - complications; Surgery; Trachea - drug effects; Germany; Sevoflurane; Postoperative Sore Throat; Airway Complication; Lidocaine; Lidocaine Group; Human; Upper respiratory tract; Respiratory disease; Anticonvulsant; Antiarrhythmic agent; Respiratory system infection; Local anesthetic; Local administration; Risk factor; Anesthesia; Complication; Organic amide; Child
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/s12630-010-9328-y

Purpose
To determine the effect of topically applied lidocaine on perioperative airway complications when using a laryngeal mask airway device (LMAD) in children either with or without a history of recent or ongoing upper respiratory tract infection (URI).
Methods
In a randomized controlled double-blind trial, 34 children with a history of recent or ongoing URI and 32 non-URI children— all of whom were younger than age ten and scheduled to undergo minor surgical procedures—were randomly assigned to either a lidocaine or a placebo group. In the lidocaine group, an LMAD was lubricated with lidocaine gel before insertion, and a clear lubricating gel was used in the placebo group. The following data were recorded after standardized anesthesia induction and airway management: postoperative complications, such as coughing, desaturation, laryngospasm, and increased oral secretions, as well as length of stay in the postanesthetic recovery unit.
Results
Children with URI had a lower overall perioperative complication rate if they received a lidocaine gel (35%) rather than placebo (94%) (
P
< 0.01). Also, the incidence of postoperative coughing was less (12%
vs
53%;
P
= 0.03). In non-URI patients, lidocaine did not significantly reduce the rate of airway complications compared with placebo (17%
vs
24%, respectively).
Conclusion
Lubrication of the LMAD with lidocaine gel reduces the incidence of airway complications in children with an upper respiratory tract infection.