Intratracheal administration of lidocaine for sedation of patients under mechanical ventilation: A double-blind randomized clinical trial

Some patients with respiratory failure who are
in need of mechanical ventilation require sedation to tolerate
the inserted endotracheal tube (ETT) and other unpleasant
stimuli. While a light sedation is satisfactory, deep sedation
can interfere with the weaning process of patient from mechanical
ventilator. Nevertheless, so far, the ideal regimen for
sedatives and analgesics has not been found. We evaluate the
effect of intratracheal administration of lidocaine for sedation of
patients under mechanical ventilation.
Methods: In a double-blind randomized clinical trial, 50 patients
aged 33–65 years who had no obvious brain injury, in need of
mechanical ventilation were enrolled into this study. They were
randomized into two groups; the treatment group received 2.5
mL of 2% lidocaine, and the control group received 2.5 mL of
normal saline via ETT each two hours for 12 h under sterile conditions.
The baseline sedation was maintained with morphine,
midazolam, or both, which were titrated to patient comfort and to
maintain an optimum sedation score throughout the entire study.
Results: During 12 h of the study, the mean±SD total morphine
and midazolam requirements were 7.13±0.96 and
4.65±1.15 mg, respectively, in the treatment group, and
11.08±0.77 and 6.37±1.17 mg, respectively, in the control
group. There was a significant (P<0.05) reduction in the requirements
for both drugs during the study in the treatment
group as compared to the control group.
Conclusion: Intratracheal administration of lidocaine significantly
reduces sedative requirements in intubated patients during
12 h. In the short-term, no side effects or complications
were observed