Objective:

To compare the efficacy (laryngeal-tracheal pain control) and safety (cardiovascular toxicity) of nebulized versus intravenous lidocaine.

Material and methods:

Randomized blinded clinical trial. Patients were allocated to receive nebulized 2% lidocaine (single doses of 2.5 mg/kg, GLN group) or intravenous lidocaine (same doses), GLIV group. The laryngeal-tracheal pain was measured on the postanesthetic period in Ramsay IV using the visual pain scale. The hemodynamic measures (heart rate [HR], systolic-median-diastolic arterial pressures [SP, MP, DP]) were evaluated at the intubation and 5-10-15 minutes after.

Results:

There were 30 patients per group. The GLN group showed less level of pain (median of 0 versus 4, p < 0.001), without change in the HR (10 minutes 65.9 ± 4 versus 84.1 ± 6, p < 0.001). The SP-MP-DP increased in both groups at the five minutes, with a later reduction in the GLN group at 10 and 15 minutes (MP15min 63 ± 4 versus 74 ± 5, p = 0.01). There were no events of hyper- or hypotension nor arrhythmias.

Conclusion:

The use of nebulized lidocaine may be more effective to control the post-intubation laryngeal-tracheal pain, with less risk of hemodynamic effects.