Lidocaine for DAI

[eric2068]

My service is currently looking into doing Drug Assisted Intubation. Any thoughts about using IV Lidocaine to decrease ICP? Please let me know.

 

[Meursault]

Pubmed is a wonderful thing:
Try this.

 

[MSDeltaFlt]

Lidocaine is only ''thought'' that it ''might'' ''help'' ''prevent'' ''possible'' increases in ICP. There is no evidence that it does. Although several protocols have it written in there.

 

[Ridryder911]

Ditto, Lidocaine was presumed to help decrease vagal tone thus assisting in the decrease of ICP when intubating.

Again, a theory.. not real facts.

R/r 911

 

[MOflightmedic]

I recently attended a critical care seminar where Neurosurgeon Peter LaTarde spoke. This question came up in the use of RSI and Dr. LaTarde said that there are no studies or evidence that the use of Lidocaine decreases ICP. He wouldn't state that it was "helpful" but he did say that there were many neurosurgeons still advocateing its use in conjunction with RSI. Dr. LaTarde wrote the head trauma portion of the current PHTLS book. He is wonderful lecturer.

 

[ems1544]

Lidocaine has limited science indicating its efficacy in decreasing ICP. If you are considering it for head injuries based on limited data than you should most certainly use it for asthmatics and reduction of acute bronchospasm. There are good studies to support it for this use.

Fred Ellinger, Jr. NREMT-P
Regional Course Director
The Difficult Airway Course: EMS
www.difficultairway.net

 

[Veneficus]

for a second I thought there was going to be a discussion on lidocaine for diffuse axonal injury. :unsure:

 

[maxwell]

Yeah, it's an old wives' tale. Can't hurt, though. Pretty pink box, too.

Wanna decrease ICP? Mannitol! (Yeah, yeah, don't get excited, I know it's controversial...)