Comparison of bolus administration effects of lidocaine on preventing tourniquet-induced hypertension in patients undergoing general anesthesia: a randomized controlled trial
Anesthesia and Pain Medicine 2022³â 17±Ç 1È£ p.35 ~ p.43
±èÁö¿í(Kim Ji-Wook) - Kosin University College of Medicine Department of Anesthesiology and Pain Medicine
À̾ƶõ(Lee A-Ran) - Ulsan University Hospital Department of Anesthesiology and Pain Medicine
¹ÚÀº¼±(Park Eun-Sun) - Ulsan University Hospital Department of Anesthesiology and Pain Medicine
À±¹Î¼ö(Yun Min-Su) - Kosin University College of Medicine Department of Anesthesiology and Pain Medicine
·ù¼º¿ø(Ryu Sung-Won) - Kosin University College of Medicine Department of Anesthesiology and Pain Medicine
±è¿í°ü(Kim Uk-Gwan) - Kosin University College of Medicine Department of Anesthesiology and Pain Medicine
°µ¿Èñ(Kang Dong-Hee) - Kosin University College of Medicine Department of Anesthesiology and Pain Medicine
±èÁÖ´ö(Kim Ju-Deok) - Kosin University College of Medicine Department of Anesthesiology and Pain Medicine
Abstract
Background: This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia.
Methods: This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded.
Results: SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001).
Conclusion: Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.
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Hypertension, Ketamine, Lidocaine, Pain, Tourniquets
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SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001).