Preoperative nebulised lidocaine for children with mild symptoms of upper respiratory tract infections: A randomised controlled trial

Abstract

Nebulised lidocaine was previously used in infants and children undergoing flexible bronchoscopy and was safe and beneficial. The aim of this randomised controlled trial was to assess the impact of preoperative nebulised lidocaine on the incidence of perioperative respiratory adverse events in children aged one to five years proposed for ilioinguinal ambulatory surgery while having mild symptoms of upper respiratory tract infection. Patients were randomly allocated to one of the two groups of the study: Group L (lidocaine) received 4 mg/kg of nebulised lidocaine 2% (0.2 ml/kg), and Group P (placebo) received 0.2 ml/kg of normal saline nebulisation, 30 minutes before anaesthesia. Nebulised lidocaine reduced the risk of bronchospasm, with p = 0.003 and a risk ratio (RR) = 0.326 [0.140-0.760], and prolonged oxygen support postoperatively, with p = 0.004 and RR = 0.222 [0.067-0.732]. It also reduced the risk of hospitalisation, with p = 0.001 and RR = 0.138 [0.033-0.577]. No side effects for nebulised lidocaine 2% were noted. Preoperative nebulised lidocaine seems to be a safe and efficient premedication for children with upper respiratory tract infections.

Keywords: Anaesthetics–management and care; Outcomes; Paediatric surgery; Patient safety; Risk management.