Document Type : Original Article


1 Anesthesiology and critical research center,Isfahan University of Medical Sciences.

2 Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan, Iran

3 Al Zahra Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran



Objective: This study aimed to assess and compare the effects of intranasal administration of lidocaine and
remifentanil on the condition of LMA insertion and cardiovascular response.
Methods: From March 2019 to March 2020, this double-blind randomized clinical trial study was conducted
on 60 patients, who underwent general anesthesia with LMA insertion at Faiz Hospital, Isfahan, Iran. After
induction of anesthesia and before placing the laryngeal mask, the first group received remifentanil 1 μg/Kg,
the second group received lidocaine 2% 1 mg/Kg, and the third group received normal saline with the same
volume intranasally. The conditions of LMA insertion and hemodynamic changes that occurred during its
insertion were investigated.
Results: In terms of demographics characteristics (p>0.05), success in placing the LMA on the first try
(p=0.73), number of attempts to insert LMA (p=0.61), performance of LMA (p=0.73), need for additional
propofol (p=0.53), frequency of gagging (p=0.53), cough (p=0.15) p), and laryngospasm (p=0.99) did not
differ significantly. In the remifentanil group, the cardiovascular response to LMA injection was less than that
of the lidocaine group. Moreover, both groups were lower than the saline group, but no significant difference
was observed
Conclusion: In facilitating LMA insertion, the effect of intranasal remifentanil was comparable to intranasal
lidocaine. Intranasal remifentanil was somewhat more effective than intranasal lidocaine in weakening the
cardiovascular response to LMA insertion, but it did not outperform lidocaine.