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The use of preoperative lidocaine to prevent stridor and laryngospasm after tonsillectomy and adenoidectomy.

Abstract
The most important complications from tonsillectomy and adenoidectomy are bleeding, stridor, and laryngospasm. This controlled, double-blind study was designed to investigate the effects of topical and intravenous lidocaine on stridor and laryngospasm. A total of 134 patients scheduled for elective tonsillectomy and/or adenoidectomy were randomly separated into four groups. In the topical lidocaine group 4 mg/kg of 2% lidocaine was applied to subglottic, glottic, and supraglottic areas before endotracheal intubation. Normal saline solution was used topically for the first control group. In the intravenous lidocaine group, patients were given 1 mg/kg of 2% lidocaine before extubation, and the same amount of 0.9% NaCl was given to the second control group. Postoperative stridor, laryngospasm, cyanosis, bleeding, sedation degree, and respiratory depression were observed, and plasma lidocaine levels were measured. Both topical and intravenous lidocaine groups revealed less stridor and laryngospasm than the control groups, and no difference was found between the topical and intravenous lidocaine groups except the higher sedation scores in the early postoperative period for the intravenous lidocaine group.
AuthorsC Koç, F Kocaman, E Aygenç, C Ozdem, A Cekiç
JournalOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 118 Issue 6 Pg. 880-2 (Jun 1998) ISSN: 0194-5998 [Print] England
PMID9627258 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anesthetics, Local
  • Lidocaine
Topics
  • Adenoidectomy
  • Anesthetics, Local (therapeutic use)
  • Child
  • Female
  • Humans
  • Laryngismus (etiology, prevention & control)
  • Lidocaine (therapeutic use)
  • Male
  • Postoperative Complications (prevention & control)
  • Preoperative Care
  • Respiratory Sounds
  • Tonsillectomy
  • Treatment Outcome

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