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Lidocaine plasma concentrations in pediatric patients after providing airway topical anesthesia from a calibrated
1Department of Pediatric Anesthesiology, University Hospital of Tours, France.
Insights
Laryngeal spray with 5% lidocaine is safe for infants and children undergoing airway procedures. This study found plasma lidocaine concentrations remained within safe limits after administration.
Area of Science:
- Pediatric Anesthesiology
- Pharmacokinetics
- Airway Management
Background:
- Lidocaine is commonly used for local anesthesia during airway procedures.
- Data on plasma lidocaine concentrations after laryngeal spray in pediatric patients is limited.
- Ensuring safe anesthetic practices in infants and children is crucial.
Purpose of the Study:
- To evaluate plasma lidocaine concentrations in pediatric patients following laryngeal spray.
- To determine the safety and efficacy of 5% lidocaine spray for airway procedures in children.
Main Methods:
- Prospective study involving 21 pediatric patients (3-24 months) undergoing laryngoscopy or bronchoscopy.
- Lidocaine administered via 5% spray (0.9-2.6 mg/kg) after mask induction with halothane.
- Plasma lidocaine concentrations measured to determine maximum concentration (Cmax).
Main Results:
- Maximum plasma lidocaine concentration (Cmax) averaged 1.05 +/- 0.55 micrograms/mL (range: 0.24-2.29 micrograms/mL).
- Doses administered ranged from 0.9 to 2.6 mg/kg.
- Observed concentrations were within established safe limits for lidocaine.
Conclusions:
- Laryngeal spray administration of 5% lidocaine is a safe method for pediatric patients.
- The evaluated doses and resulting plasma concentrations support the safety of this technique.
- This study provides valuable pharmacokinetic data for pediatric airway management.
Abstract:
The aim of this prospective study was to evaluate plasma lidocaine concentrations in infants and children after laryngeal spray using a calibrated device. Twenty-one patients aged 3 to 24 mo requiring laryngoscopy or bronchoscopy were included in the study. Anesthesia was induced via a mask with halothane up to 2% in 100% O2. Lidocaine was administered using a 5% lidocaine spray. For patients weighing less than 10 kg, one spray (8 mg of lidocaine) was administered. For those weighing from 10 to 20 kg, two sprays (16 mg) were given. The dose of lidocaine administered ranged between 0.9 and 2.6 mg/kg. Maximum plasma lidocaine concentration (Cmax) was 1.05 +/- 0.55 micrograms/mL (mean +/- SD; range 0.24-2.29 micrograms/mL). With this procedure, we demonstrated the safety of administering lidocaine to children by laryngeal spraying using a 5% sprayer.