فهرست نشریات علمی دسترسی آزاد ایران

Objectives: This randomized controlled trial aimed to evaluate the effect of pre-extubation intravenouslidocaine (1 mg/Kg) on the incidence of airway complications and hemodynamic stability in patients undergoingemergency laparoscopic cholecystectomy, while accounting for age differences.Methods: The study was a prospective, single-center, randomized controlled trial conducted from 2021 to 2023at Imam Khomeini Hospital, Ilam, Iran. Ninety patients undergoing emergency laparoscopic cholecystectomywere classified into two age groups (<50 and ≥50 years) and randomly assigned to receive either intravenouslidocaine (1 mg/Kg) or a standard extubation protocol. The primary outcomes included post-extubationairway complications, such as laryngospasm, cough, and sore throat, and the secondary outcomes includedhemodynamic and respiratory parameters.Results: Lidocaine produced hemodynamic effects that differed by age group. In patients <50 years, systolicblood pressure (SBP) increased from 129.2±16.4 mmHg to 133.1±23.1 mmHg, while diastolic blood pressure(DBP) rose from 83.9±14.4 mmHg to 92.3±19.4 mmHg (both p<0.001). Conversely, in patients ≥50 years old,SBP decreased from 160.5±26.7 mmHg to 145.2±19.7 mmHg, and DBP decreased from 107.9±19.5 mmHg to99.0±16.1 mmHg (both p<0.001). Airway complications exhibited non-significant tendencies, with a decreasedincidence of cough in the older age group (15.6% vs. 31.8%) and an absence of laryngospasm in this age group.There were no serious adverse events (e.g., bronchospasm, arrhythmias).Conclusion: Intravenous lidocaine was safe and demonstrated a trend toward reducing airway complicationsat extubation in patients undergoing emergency laparoscopic cholecystectomy, particularly in elderly patients.However, this trend did not reach statistical significance, most likely due to insufficient statistical power.