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

Mohamed R. El-Tahan, Osama M. Warda, Douaa G. Diab, Eyad A. Ramzy, Mohamed K. Matter

Research output: Contribution to journalJournal articlepeer-review

29 Scopus citations

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·kg-1 i.v. bolus 30 min before induction, followed by an infusion of 1.5 mg·kg-1 ·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 μg·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 μg·mL- and 1.06 ± 0.31 μg·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.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalJournal of Anesthesia
Volume23
Issue number2
DOIs
StatePublished - 2009

Keywords

  • Anesthesia
  • Cesarean section
  • Lidocaine
  • Stress response

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