Background: Post-extubation laryngospasm is a common and serious complication in children.
Aim of the work: The effect of intravenous lidocaine versus midazolam on the incidence and severity of post-extubation laryngospasm.
Patients and methods: This randomized clinical trial included 120 young children who were undergoing elective adenotonsillectomy. These children were randomly divided into three equal groups. Two minutes pre-extubation, these groups received intravenously either 5ml of normal saline (Control group), 1.5 mg/kg of lidocaine (L group) or 0.03 mg/kg of midazolam (M group). The incidence and severity of post-extubation laryngospasm, the means of heart rate (HR), arterial pressure (MAP), oxygen saturation (SpO2) and recovery time and the associated complications were recorded.
Results: The incidence and severity of post extubation laryngospasm in both L and M groups were statistically comparable and significantly lower than in C group. The mean HR and MAP values at 2,5,10 and 20 minutes post-extubation in L and M groups were statistically significant lower than the corresponding values in C group and in L group were significantly higher than in M group. The mean SpO2 values only at 2 min. post-extubation in C group was statistically lower than the corresponding mean values in both tested groups. Post-extubation, hypoxemia was the only associated complication and occurred in 10% of cases in C group.
Conclusion: Lidocaine (1.5 mg/kg) and Midazolam (0.03 mg/kg) have comparable safe effects in reducing the incidence and severity of pos-extubation laryngospasm when given intravenously 2 minutes pre-extubation in children undergoing adenotonsillectomy.