A Comparative Study to Determine the Effects of Variable Concentrations and Different Routes of Administration of Lidocaine in Suppressing Cough and on Hemodynamic Response During Extubation in Pediatric Age Group: An Observational Prospective Study

Objectives: The objectives of this study were to compare the effects of different concentrations of lidocaine (2% endotracheal [ET] spray; 10% ET spray; and 2% intravenous [IV]) in suppressing cough and on hemodynamic response during extubation in pediatric age groups; an observational prospective study. Methods: Ninety patients were enrolled for the study and divided into three groups. In Group A, patients were administered (1 mg/kg) of 2% lidocaine ET spray 5 min before extubation; in Group B, patients were administered (1 mg/kg) of 10% lidocaine ET spray 5 min before extubation; and in Group C patients were administered (1 mg/kg) 2% lidocaine IV 3 min before extubation. The three groups were compared for hemodynamic parameters, incidence of cough, breathing pattern, and need for continuous positive airway pressure (CPAP). Results: There was significant attenuation of hemodynamic parameters and less incidence of cough and labored breathing in patient receiving either 10% ET or 2% IV lidocaine. As compared to 2% ET lidocaine, requirement of CPAP support was less in patients who received 10% lidocaine. Patients who were administered 2% IV lidocaine did not receive any CPAP support postextubation. Conclusion: As compared to 2% lidocaine spray postextubation, both 10% lidocaine spray and 2% IV lidocaine postextubation have significantly positive effect on suppression of cough and on hemodynamic parameters.