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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2012, Vol. 6 Issue (3) : 302-306    https://doi.org/10.1007/s11684-012-0194-6
RESEARCH ARTICLE
EMLA? Cream coated on endotracheal tube with or without epidural lidocaine reduces isoflurane requirement during general anesthesia
Hai Yu, Qinjun Chu, Jin Liu(), Li Chen, Ying Wang, Yunxia Zuo
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, China
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Abstract

This study was designed to evaluate the effect of tracheal topical anesthesia using EMLA? Cream (EC) coated on the endotracheal tube (ETT) with or without epidural anesthesia (EA) on isoflurane requirement during general anesthesia (GA) and investigate whether EC coated on the ETT with EA was associated with the additive effect compared with the effect when each anesthetic was administered independently. The prospective randomized, double-blinded, and controlled study included 60 ASA I–II patients scheduled for upper abdominal surgery requiring GA. Patients were randomly assigned to one of the following groups: group 1 received GA, group 2 received EC+ GA, group 3 received GA+ EA, and group 4 received EC+ GA+ EA. Isoflurane was administered at the required concentrations to maintain the mean arterial pressure at a level not exceeding 20% of preoperative values. The percentage mean expired concentration (%MEC) was used in calculating the isoflurane requirement. Emergence agitation, postoperative sore throat, and hoarseness were recorded. Groups 2, 3, and 4 exhibited a significant reduction on isoflurane requirement compared with group 1 (P<0.05). The isoflurane requirement evaluated by %MEC decreased by 12%, 38%, and 50% in groups 2, 3, and 4, respectively. The incidence of emergence agitation was significantly lower in groups 2 and 4 than those in groups 1 and 3 (P<0.05). Tracheal topical anesthesia using EC coated on ETT with or without EA reduced the isoflurane requirement during GA, indicating that EC combined with EA exhibited an additive effect on the requirement of general anesthetic.

Keywords EMLA? Cream      epidural anesthesia      general anesthesia      isoflurane      lidocaine     
Corresponding Author(s): Liu Jin,Email:scujinliu@gmail.com   
Issue Date: 05 September 2012
 Cite this article:   
Ying Wang,Yunxia Zuo,Hai Yu, et al. EMLA? Cream coated on endotracheal tube with or without epidural lidocaine reduces isoflurane requirement during general anesthesia[J]. Front Med, 2012, 6(3): 302-306.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-012-0194-6
https://academic.hep.com.cn/fmd/EN/Y2012/V6/I3/302
Group 1Group 2Group 3Group 4
Sex (M/F)9/68/75/106/9
Age (range in years)50.1±11.454.5±8.354.1±8.252.1±8.3
Height (cm)164.0±8.1163.3±10.2164.7±8.4164.1±7.2
Weight (kg)58.2±11.661.1±10.256.2±9.060.3±8.4
Duration of Surgery (min)127.6±60.1120.3±42.7120.2±38.4130.5±42.0
Tab.1  Demographic data of groups 1 to 4
Group 1Group 2Group 3Group 4
The requirement of isoflurane
MAC-hour2.4±1.12.0±0.7*1.4±0.3*?1.2±0.4*??
Reduction in percenta012%38%50%
%MEC1.01±0.110.89±0.07*0.63±0.06*?0.51±0.08*??
Reduction in percenta012%38%50%
The consumption of fentanyl (μg)144.4±25.7132.8±22.5124.8±20.7122.1±21.4
Tab.2  Comparison of the intraoperative requirements of anesthetics
Group 1Group 2Group 3Group 4
Hemodynamic Parameters
Average error of MAP5.2±5.03.4±5.1-3.8±4.1*?-3.4±3.0*?
Absolute average error of MAP15.6±5.014.1±4.212.2±4.3*?10.9±3.1*?
Average error of HR13.3±5.312.7±6.4-3.6±5.2*?-1.8±4.0*?
Absolute average error of HR17.6±6.015.1±6.110.0±4.5*?8.7±5.1*?
Pharmacologic Interventions
Ephedrine1043
Atropine0022
Esmolol3200
Urapidil2100
Tab.3  Comparisons of intraoperative hemodynamic stability and pharmacologic interventions
Group 1Group 2Group 3Group 4
Emergence agitation8(53%)2(13%)*?6(40%)1(7%)*?
Sore throat6(40%)3(20%)5(33%)3(20%)
Hoarseness3(20%)2(13%)1(7%)2(13%)
Tab.4  Incidence of postoperative complications
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