Document Type : Original Article
Authors
1 Anesthesia Department, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
2 Anesthesiology Department, Imam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
Abstract
Objectives: This randomized controlled trial aimed to evaluate the effect of pre-extubation intravenous
lidocaine (1 mg/Kg) on the incidence of airway complications and hemodynamic stability in patients undergoing
emergency laparoscopic cholecystectomy, while accounting for age differences.
Methods: The study was a prospective, single-center, randomized controlled trial conducted from 2021 to 2023
at Imam Khomeini Hospital, Ilam, Iran. Ninety patients undergoing emergency laparoscopic cholecystectomy
were classified into two age groups (<50 and ≥50 years) and randomly assigned to receive either intravenous
lidocaine (1 mg/Kg) or a standard extubation protocol. The primary outcomes included post-extubation
airway complications, such as laryngospasm, cough, and sore throat, and the secondary outcomes included
hemodynamic and respiratory parameters.
Results: Lidocaine produced hemodynamic effects that differed by age group. In patients <50 years, systolic
blood pressure (SBP) increased from 129.2±16.4 mmHg to 133.1±23.1 mmHg, while diastolic blood pressure
(DBP) rose from 83.9±14.4 mmHg to 92.3±19.4 mmHg (both p<0.001). Conversely, in patients ≥50 years old,
SBP decreased from 160.5±26.7 mmHg to 145.2±19.7 mmHg, and DBP decreased from 107.9±19.5 mmHg to
99.0±16.1 mmHg (both p<0.001). Airway complications exhibited non-significant tendencies, with a decreased
incidence of cough in the older age group (15.6% vs. 31.8%) and an absence of laryngospasm in this age group.
There were no serious adverse events (e.g., bronchospasm, arrhythmias).
Conclusion: Intravenous lidocaine was safe and demonstrated a trend toward reducing airway complications
at extubation in patients undergoing emergency laparoscopic cholecystectomy, particularly in elderly patients.
However, this trend did not reach statistical significance, most likely due to insufficient statistical power.
Keywords
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