Lidocaine as Endotracheal Tube Cuff Inflating Agent (original) (raw)
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Lidocaine 10% in the endotracheal tube cuff: blood concentrations, haemodynamic and clinical effects
European Journal of Anaesthesiology, 2000
The purpose of this study was to evaluate the effects (common haemodynamic variables, peak cuff pressures, the incidence of reaction (`bucking') during extubation and the incidence of sore throat after operation) of lidocaine 10% instilled into the endotracheal tube cuff in intubated patients. Plasma concentrations of lidocaine were assayed. Seventy ASA class I±II patients scheduled for plastic surgery were studied. Patients were randomly divided in two groups: the cuff of the endotracheal tube was in¯ated with either lidocaine 10% (group L) or with saline (group S) immediately after endotracheal intubation. In group L patients, the haemodynamic changes were less (P < 0.05), and the peak cuff pressure was lower (P < 0.01) than for group S. At extubation, more patients reacted (`bucked') in group S (70.5% vs. 19.4%, P < 0.01). The incidence and severity of sore throat were signi®cantly lower in group L 1 and 24-h after extubation. Plasma lidocaine concentrations did not reach toxic values. Lidocaine 10%, compared with saline, in the endotracheal tube cuff was associated with less disturbance of haemodynamic responses and less incidence of bucking during tracheal extubation. Lidocaine was also effective in reducing of incidence and severity of sore throat after operation.
La Tunisie médicale, 2014
Tracheal intubation results in an alteration of the laryngeal mucosa which can lead to undesirable effects at emergence from anaesthesia. Local anesthetics, when administered topically, may represent an interesting alternative to reduce these side effects. In this trial, we aimed to evaluate the effect of lidocaine in preventing tracheal intubation related side effects at emergence from anaesthesia, when instilled onto the glottis before intubation or used to inflate the endotracheal tube cuff. Eighty patients scheduled to elective surgery of less than 120 minutes under general anaesthesia were enrolled in this prospective, randomized, controlled, double blind study. As they receive instillation of 2% lidocaine or saline onto the glottis before intubation, and as they have their endotracheal tube cuff filled with 2% lidocaine or saline, the patients were randomized in four groups. S-S (Saline instillation and saline in the cuff); S-Lido (saline instillation and lidocaine in the cuff...
Background: Endotracheal intubation for airway management in general anaesthesia is associated with post intubation morbidities due to prolonged inflation of the ETT cuff. Many studies have used Lidocaine by instillation in the ETT cuff and its diffusion to the underlying tracheal mucosa there by reducing local irritation and inflammation of the airway. Aims: To study the favorable effects of lidocaine(4%)instillation in the endotracheal tube cuff in surgical patients as compared to air. Settings and design: The study was done in a multispeciality teaching hospital. Eighty patients were selected and randomly divided into two groups. Methods and Material: Eighty patients of ASA – I & II status posted for general surgery were randomly selected and divided into two groups after randomization.All these general surgeries lasted for duration of 30-45 minutes. Blood loss intraop.was around 200-300ml only. All these patients received first dose of I.V.fentanyl for analgesia at induction. In forty patients air was filled in ETT cuff and in remaining patients lidocaine (4%) 3-5ml was instilled keeping the cuff pressure between 20-22mmHg. Coughing and hemodynamic parameters were noted at and after extubation. Intubation related morbidities were compared between the two groups. Patients with hypertension, COPD, recurrent respiratory infections etc. and those needing postop ventilator supports were excluded. Statistical analysis used: The database of all parameters were analysed using “STATA SOFTWARE VERSION10.0”. Results: The study showed a significant difference in the incidence of post-operative sore throat in group I(air) and group II (lidocaine). Lidocaine group had lesser sore throat incidence. There was no significant change in heart rate initially but showed a significant change in both the study groups at later intervals. Similarly there was a highly significant change in blood pressure in both the study groups at 2, 5, 10, 30 and 60 min after extubation. Conclusions: Lidocaine can be used for instillation in ETT cuff to minimize the postintubation morbidities.
Research and Practice in Anesthesiology – Open Journal, 2018
Post-operative sore throat (POST) represents a real discomfort for patients. In short duration surgeries, sore throat complain can replace the post-operative pain. Many studies intended to reduce its incidence using multiples medications. Objective Assess the efficiency of extra cuff lidocaine jelly 2% associated with intra cuff liquid lidocaine 2% on the post extubation syndrome. Materials and method Prospective study lead during 3 months in Otorhinolaryngology operating rooms. Inclusion criteria: Every intubation (naso or orotracheal) performed during this period. Exclusion criteria: upper airways surgery, tonsillectomy and patient's refusal. Patients were randomized in 3 groups: First (G1): Control group (inflated cuff with air), Second (G2): liquid lidocaine 2% injected intra cuff, Third (G3): Lidocaine 2% jelly applied on the external surface of the cuff associated with liquid lidocaine intra cuff. Patients were assessed for post-operative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery. Results Ninety-nine patients were randomized (G1 n=30, G2 n=34, G3 n=35). The association of liquid and jelly lidocaine reduced POST at H1, H6, and H24 after patient's discharge (p respectively at 0.0001; 0.002; 0.003 and 0.004). There was no significant difference in blunting coughing (p=0.053) and post-operative nausea and vomiting (p=0.198) Conclusion The association of liquid and jelly lidocaine was efficient in reducing the POST. This result needs to be supported by a larger study including an important number of patients.
Sao Paulo Medical Journal, 2007
CONTEXT AND OBJECTIVE: High intracuff pressure in endotracheal tubes (ETs) may cause tracheal lesions. The aim of this study was to evaluate the effectiveness and safety of endotracheal tube cuffs filled with air or with alkalinized lidocaine. DESIGN AND SETTING: This was a prospective clinical study at the Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Among 50 patients, ET cuff pressures were recorded before, 30, 60, 90 and 120 minutes after starting and upon ending nitrous oxide anesthesia. The patients were randomly allocated to two groups: Air, with ET cuff inflated with air to attain a cuff pressure of 20 cmH2O; and Lido, with ET cuff filled with 2% lidocaine plus 8.4% sodium bicarbonate to attain the same pressure. ET discomfort before tracheal extubation, and sore throat, hoarseness and coughing incidence were studied at the time of discharge from the post-anesthesia care unit, and sore throat and hoarseness were stu...
European Journal of Cardiovascular Medicine, 2023
Background: Endotracheal intubation is a common procedure during general anaesthesia, often associated with post-operative complications such as sore throat and emergence cough. This study aimed to investigate the efficacy of three intra-cuff solutions—air, normal saline, and 2% lignocaine—in mitigating these complications and their impact on intubation attempts and hemodynamic parameters. Methods: A randomized clinical trial was conducted involving 114 patients undergoing elective surgeries. Participants were divided into three groups based on the intra-cuff solution used. Intubation attempts, post-operative sore throat, emergence cough, and physiological parameters were assessed and statistically analysed. Results: The use of 2% lignocaine significantly reduced the number of intubation attempts (p < 0.001*) compared to air and normal saline. Additionally, lignocaine was associated with a significantly lower incidence of post-operative sore throat (p = 0.011*) and emergence cough (p = 0.010*) compared to the other solutions. However, there were no significant differences in hemodynamic parameters between the groups. Conclusion: This study suggests that 2% lignocaine may be a preferable intra-cuff solution for endotracheal intubation, as it reduces intubation attempts and the incidence of post-operative complications. Further research and clinical trials are needed to validate these findings and refine the selection criteria for intra-cuff solutions.
Postoperative sore throat (POST) is a common complication after endotracheal intubation. After tracheal intubation, the incidence of sore throat varies from 14.4% to 50%. The aim of the study was to compare between bezydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on the endotracheal tube cuff as regards postoperative sore throat. The present study was carried out on 124 patients admitted to Alexandria university hospitals for lumbar fixation surgery requiring general anesthesia. Patients were randomly allocated into 4 groups. Benzydamine hydrochloride gel, 5% lidocaine hydrochloride gel, 10 % lidocaine hydrochloride spray, or normal saline were applied on ETT cuffs before endotracheal intubation. The patients were examined for sore throat (none, mild, moderate, or severe) at 0, 1, 6, 12, and 24 hours after extubation. The results were collected, analyzed and presented in tables and figures.The highest incidence of POST occurred at 6 hours after extubation in all groups. There was a significantly lower incidence of POST in the benzydamine group than 5% lidocaine gel, 10% lidocaine spray, and normal saline groups. The benzydamine group had significantly decreased severity of POST compared with the 10% lidocaine, 5% lidocaine, and normal saline groups at observation time point. Compared with the 5% lidocaine the 10% lidocaine group had significantly increased incidence and severity of POST after extubation. Compared with normal saline the 10% lidocaine group had increased incidence of POST, yet the severity of POST was increased in the saline group. There were no significant differences among groups in local or systemic side effects. So in conclusion, benzydamine hydrochloride gel on the ETT cuff is a simple and effective method to reduce the incidence and severity of POST. Application of 10% lidocaine spray should be avoided because of worsening of POST where incidence increased but not the severity in relation to 5%lidocaine gel. Applying 5% lidocaine on the ETT cuff does not prevent POST but its application is better than lidocaine 10%spray or saline.
International Journal of Basic & Clinical Pharmacology, 2020
Background: Sore throat and cough during emergence are common side effects of general anaesthesia and its incidence is reported by 30-70% of patients after tracheal intubation. Also, not to forget the hemodynamic fluctuations associated with it, adds on to the magnitude of the problem. Thinking of a simple and cost-effective way to tackle this problem, this study was undertaken to determine the benefits of using intra-cuff lignocaine to prevent post intubation sore throat and emergence cough. The objective of this study to assess the efficacy of intra-cuff 2% lignocaine solution, in reducing emergence cough and post-operative sore throat after extubation in general surgery patients intubated for 2-4 hours.Methods: A prospective observational study where 100 ASA I and II status patients divided into 2 groups of 50 each was compared. In one group ETT cuff was filled with air, while in the other group, 2% plain lignocaine solution was used. Side effects like sore throat, coughing and b...