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Article
October 1991

The Prevention of Postoperative Stridor and Laryngospasm With Topical Lidocaine

Author Affiliations

From the Division of Otolaryngology/Head and Neck Surgery (Drs Staffel, Weissler, and Drake) and Department of Anesthesia (Dr Tyler), University of North Carolina School of Medicine, Chapel Hill.

Arch Otolaryngol Head Neck Surg. 1991;117(10):1123-1128. doi:10.1001/archotol.1991.01870220071012
Abstract

• Tonsillectomy and adenoidectomy can predispose to stridor and laryngospasm in the immediate postextubation period. A prospectively randomized study of 133 patients undergoing tonsillectomy and adenoidectomy was undertaken to determine if the topical application of 4 mg/kg of 4% lidocaine at the time of intubation would decrease the incidence of postoperative stridor and laryngospasm. Taken together, eight (12%) of 67 control patients suffered stridor or laryngospasm vs two (3%) of 66 patients receiving lidocaine. It is concluded that lidocaine administered topically at the time of intubation for adenotonsillectomy helps prevent postoperative stridor and laryngospasm. Surgery of the upper aerodigestive tract often involves not only the technical aspects of the surgical procedure but also concomitant management of the airway. This can present a challenge to even the most adept otolaryngologist and anesthesiologist. Accidental extubation is always possible, and reintubation can be difficult in the presence of blood and saliva. The difficulty is often compounded with a patient who is not completely paralyzed.

(Arch Otolaryngol Head Neck Surg. 1991;117:1123-1128)

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