Fact or Fantasy? Lidocaine for RSI in Patients with Major Head Injury

Lidocaine is commonly used in the U.S. to mitigate the increase in intracranial pressure (ICP) that can occur during intubation of patients with already elevated . . .

Lidocaine is commonly used in the U.S. to mitigate the increase in intracranial pressure (ICP) that can occur during intubation of patients with already elevated ICP caused by injury or mass. These authors from the U.K., where lidocaine is not used for this purpose, conducted an evidence-based literature search to answer the question of whether lidocaine used during rapid-sequence intubation (RSI) improves outcome in head-injured patients.

After an extensive literature search and rigorous application of principles of evidence-based medicine, the authors identified only 6 relevant studies, none of which directly answered the question or addressed outcomes. The authors recommended that the practice be abandoned and that lidocaine be used only …

Reviewing Author

Diane M. Birnbaumer, MD, FACEP