Uso de lidocaína intravenosa como coadyuvante previo a la intubación en pacientes con traumatismo craneoencefálico: una scoping review de la evidencia disponible
DOI:
https://doi.org/10.71112/r0z9s483Palavras-chave:
Traumatismo craneoencefálico, Lidocaína intravenosa, Intubación orotraqueal, Secuencia de intubación rápida, Presión intracraneal, Presión de perfusión cerebral, Respuesta hemodinámica, Manejo de la vía aérea, Paciente neurocrítico.Resumo
El traumatismo craneoencefálico (TCE) representa una causa importante de morbimortalidad, en la cual la intubación orotraqueal constituye una intervención crítica para asegurar la vía aérea y prevenir la lesión cerebral secundaria. Sin embargo, la laringoscopia y la intubación pueden inducir una respuesta simpática que incrementa la presión intracraneal (PIC) y compromete la presión de perfusión cerebral (PPC). En este contexto, la lidocaína intravenosa ha sido utilizada como coadyuvante previo a la intubación con el objetivo de atenuar estos efectos fisiológicos. El presente estudio tuvo como objetivo mapear la evidencia disponible sobre su uso en pacientes con TCE mediante una scoping review.
Se realizó una revisión de alcance siguiendo los lineamientos metodológicos de Arksey and O'Malley y reportada conforme a PRISMA-ScR. Se efectuó una búsqueda sistemática en bases de datos biomédicas, identificándose 500 registros, de los cuales 20 estudios cumplieron con los criterios de inclusión. Los estudios fueron heterogéneos en diseño, población y contexto clínico. La mayoría evaluó desenlaces fisiológicos inmediatos, como cambios en PIC, PPC y variables hemodinámicas, con escasa evaluación de desenlaces clínicos relevantes.
Los resultados sugieren que la lidocaína intravenosa puede atenuar de forma parcial la respuesta intracraneal y hemodinámica asociada a la intubación; sin embargo, estos efectos no son consistentes ni se traducen claramente en beneficios clínicos significativos. La evidencia disponible es limitada y en gran parte indirecta, derivada de contextos distintos al manejo agudo del TCE en emergencia. En consecuencia, no existe suficiente evidencia para recomendar su uso rutinario como pretatamiento en la secuencia de intubación rápida, siendo necesarios estudios de mayor calidad metodológica que evalúen su impacto en desenlaces clínicamente relevantes.
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Copyright (c) 2026 Byron Andres Chamba Lapo, Patricia Fernanda Galárraga Carrillo, Kevin Hair Taipe Mayorga, Xiomara Belen Ramos Morales, Daniela Estefania Manotoa Molina (Autor/a)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
