A randomized study of the effects of perioperative i.v. lidocaine on hemodynamic and hormonal responses for cesarean section.

Abstract:

PURPOSE:Intravenous infusion of lidocaine attenuates the stress response to surgery. We aimed to evaluate the effects of perioperative lidocaine on the hemodynamic and hormonal responses for cesarean delivery. METHODS:After the gaining of ethical approval, 90 patients scheduled for elective cesarean delivery were randomly allocated to receive either lidocaine 1.5 mg x kg(-1) i.v. bolus 30 min before induction, followed by an infusion of 1.5 mg x kg(-1) x h(-1) until 1 h after surgery (n = 45), or saline placebo (n = 45). Anesthesia was maintained with 50% nitrous oxide in oxygen with 0.7% isoflurane. Hemodynamic variables, plasma cortisol, maternal and neonatal lidocaine concentrations, Apgar scores at 1 and 5 min, neonatal acid-base status, and the neurologic and adaptive capacity score (NACS) were recorded. RESULTS:After induction, patients receiving lidocaine had a smaller increase in heart rate and mean arterial blood pressure (P < 0.02) and lower plasma cortisol concentrations (31.1 +/- 9.91 vs 45.6 +/- 8.43 microg x dL(-1); P < 0.001). There were no differences between the two groups in Apgar scores, NACS, or neonatal acid-base status. After delivery, maternal and umbilical venous concentrations and umbilical vein-to-maternal vein ratios of lidocaine were 2.05 +/- 0.42 microg x mL(-) and 1.06 +/- 0.31 microg x mL(-1), and 0.52 +/- 0.07, respectively. CONCLUSION:Perioperative lidocaine is safe and effective in attenuating the maternal stress response to surgery for cesarean delivery.

journal_name

J Anesth

journal_title

Journal of anesthesia

authors

El-Tahan MR,Warda OM,Diab DG,Ramzy EA,Matter MK

doi

10.1007/s00540-009-0738-3

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

215-21

issue

2

eissn

0913-8668

issn

1438-8359

journal_volume

23

pub_type

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