Deok Hee Lee

Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation.

Background It is well known that suspension laryngoscopy (SL) produces marked hemodynamic changes. Coughing during extubation sometimes causes adverse clinical problems. We investigated whether 10% lidocaine spray could attenuate hemodynamic stress responses due to SL and reduce coughing incidence during extubation. Methods Sixty patients undergoing SL were randomly divided into two groups and intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine, sprayed onto laryngeal and intratracheal sites 2 min prior to intubation (10% lidocaine group). Mean arterial pressure (MAP) and heart rates (HR) during SL and coughing incidence during extubation were recorded. Results MAP at 2.5 and 5 min (P < 0.05) and HR at 2.5 min after SL (P < 0.01) were greater in the control group than in the 10% lidocaine group. The number of coughs decreased in the 10% lidocaine group compared to the control group during pre- (6.8 ± 3.2 vs 10.3 ± 4.4, P < 0.01) and post-extubation period of 5 min (4.0 ± 2.3 vs 6.2 ± 4.2, P < 0.05) and during the entire study period (10.8 ± 3.9 vs 16.5 ± 5.6, P < 0.001). Conclusions Preoperative laryngeal and intratracheal spraying with 1.5 mg/kg of 10% lidocaine spray is effective for attenuation of arterial pressure increase to SL and suppression of coughing during extubation.

Is the Airtraq optical laryngoscope effective in tracheal intubation by novice personnel

Background Macintosh laryngoscopic intubation is a lifesaving procedure, but a difficult skill to learn. The Airtraq optical laryngoscope (AOL) is a novel intubation device with advantages over the direct laryngoscope for untrained personnel in a manikin study. We compared the effectiveness of AOL with Macintosh laryngoscope for tracheal intubation by novice personnel. Methods We selected 37 medical students with no prior tracheal intubation experience and educated them on using both laryngoscopes. Seventy-four patients were randomly divided into two groups (group A: AOL, group M: Macintosh laryngoscope). We recorded the tracheal intubation success rate, intubation time, number of attempts, intubation difficulty scale, and adverse effects. Results The total success rate was similar in the two groups, but the success rate at first attempt was higher in group A (P < 0.01). Group A also showed reduced duration and attempts at intubation, as well as adverse effects such as oral cavity injury. Additionally, participant reports indicated that using the AOL was easier than the Macintosh laryngoscope (P < 0.01). Conclusions The AOL is a more effective instrument for tracheal intubation than Macintosh laryngoscope when used by novice personnel.