effects of intravenous lidocaine on airway complications and hemodynamic stability following emergency laparoscopic cholecystectomy: a randomized controlled trial in different age groups

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.