Resumen

CUERVO SOLANO, Juan Andrés; AMAYA BERNA, swaldo  y  CHAVES VEGA, Alexandra. Uso de lidocaína hiperbárica endotraqueal en cirugía endoscòpica Laringea , estabilidad hemodinámica y control del dolor postoperatorio . Rev. colomb. anestesiol. [online]. 2007, vol.35, n.3, pp.243-245. ISSN 0120-3347.

Laryngeal endoscopic surgery is a growing field according with the technological advances of the surgical techniques as well as the management of the airway by the anesthesiologists. For this purpose there is an airway device called Monjet , that allows, oxigenation , ventilation, and an excellent surgical field for the laringeal lesions because it uses small space in the glotis , so the anesthesiologist and the surgeon can share the surgical field. Objective : This study compared the administration of Heavy endotraqueal lidocaine administered in the anesthetic induction and its effects on the hemodinamic stability and its role in the management of the postoperative Pain, blocking the afferent stimulus of the manipulation of glothic structures. Materials and methods : 20 patients ASA 1 - 2 were ramdomised in two different groups, 9 patients were assigned to the hyperbaric lidocaine group, and 11 patients to the control group. We used standard anesthetic induccion whit midazolam , propofol , rocuronium , an remifentanil . In the lidocaine group we administered 100 mg of hyperbaric lidocaine with an aspersion cannulae . The hemodinamica variables, Sistólic , diastolic and median Blood Pressure, were measured at 4 diferent times. (Basal, Inducction , average of 30 first minutes and average of minutes 30 to 60). We also measured using the visual analogue scale, the pain perseption after the surgery in 3 specific moments (10, 30 and 60 minutes after surgery). Results: There was no evidence of increased hemodynamic stability in terms of blood pressure and cardiac frecuency in the group using the lidocaine vs the control group. Nevertheless there was better control of the postoperative pain management in the lidocaine group, at 10 , 30 and 60 minutes after surgery. Conclusion : 1. The use of hiperbaric lidocaine in laryngeal endoscopic surgery do not offer hemodynamic stability in terms of blood pressure and cardiac frecuency . 2. The use of endotraqueal hiperbaric lidocaine in patients of endoscopic laringeal surgery dimminish the pain persepction in significant manner in the post operative period.

Palabras clave : laryngeal endoscopi surgery; hyperbaric lidocaine; hemodinamic stability.

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