ct results of smooth muscle relaxation.) (Forbes & Dally, 1970; Nagelhout & Zaglaniczny, 2001).
Lidocaine can be sprayed topically or it can be administered intravenously. This leads to a blunting of the side effects of endotracheal intubation. It is theorized that both administrations result in a blocking of sodium channels, a decrease in depolarization, a decrease in sympathetic nervous system stimulation, and a decrease in catecholamine release. (tachacardia and hypertension) (Morgan & Mikhail, 1996).
While research presents findings regarding the negative effects of laryngoscopy and endotracheal intubation, as well as positive effects of lidocaine use, it remains controversial as to which method of administration is more effective. Some have shown that both intravenous and topical use of lidocaine had positive effects, others have shown intravenous administration to be superior to topical administration, and still others have shown no protection from either type of administration (Laurito, Baughman, Becker, Polek, Riegler, & VadeBoncouer, 1988; Stoelting, 1977; Youngberg, Graybar, & Hutchings, 1983). Previous research also demonstrates differences in findings resulting from timing of administration, which may have effected results in all studies. For example, Wilson, Meiklejohn, & Smith, 1991) found that intravenous administration of lidocaine 4 minutes prior to laryngoscopy was effective but 2 minutes prior had no effect. A study is needed to resolve this controversy and determine the most effective route of lidocaine administration.
The purpose of this study is to determine if there is a difference in the effectiveness of topical and intravenous application of lidocaine for the blunting of increased heart rate and blood pressure in patients undergoing laryngoscopy and intubation.
The nurse anesthetist has the goal of assisting the patient to the greatest degree, without harm. This expertise will return the ...