How effective is intra-cuff lignocaine in reducing post-operative sore throat and emergence cough: a comparative study

Jithin Mathew Abraham; Saramma Abraham; Sangeetha Merrin Varghese

doi:10.18203/2319-2003.ijbcp20203139

Authors

Jithin Mathew Abraham Department of Anaesthesiology, Believers Church Medical College, Thiruvalla, ‎Kerala, India
Saramma Abraham Department of Anaesthesiology, Pushpagiri Medical College, Thiruvalla, Kerala, India
Sangeetha Merrin Varghese Department of Community Medicine, Believers Church Medical College, Thiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20203139

Keywords:

Intra-cuff, Lignocaine, Sore throat, Intubation, Emergence cough

Abstract

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 blood pressure changes were assessed. Chi square and t-tests were used to compare the findings.

Results: Among those patients where intra-cuff lignocaine was used, only 27.5% complained of sore throat and 12.5% had emergence cough, whereas among those patients where intra-cuff air was used, 72.5% had post-operative sore throat and 87.5% of patients had cough on emergence.

Conclusions: This study proves that 2% intra-cuff lignocaine is an effective method in reducing post-operative sore throat and emergence cough and thereby beneficial in controlling the hemodynamic changes associated with emergence.

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References

Harding C, McVey F. Interview method affects incidence of postoperative sore throat. Anaesthesia. 1987;42:1104-7.

Chung HPF, Mezei G. Post-operative sore throat after ambulatory surgery. Br J Anaesth. 2002;88:582.

Steinhaus JE, Gaskin I. A study of intravenous lidocaine as a suppressant of cough reflex. Anesthesiology. 1963;24:285-90.

Yukioka H, Yoshimoto N, Nishimura K, Fujimori M. Intravenous lidocaine as a suppressant of coughing during tracheal intubation. Anesth Analg. 1985;64:1189-92.

Stoelting RK. Blood pressure and heart rate changes during short duration laryngoscopy for tracheal intubation: influence of viscous or intravenous lidocaine. Anesth Analg. 1978;57:197-9.

Stoelting RK. Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. Anesthesiology. 1977;47:381-3.

Hamill JF, Bedford RF, Weaver DC, Colohan AR. Lidocaine before endotracheal intubation: intravenous or laryngotracheal. Anesthesiology. 1981;55:578-81.

Prengel AW, Lindner KH, Hahnel JH, Georgieff M. Pharmacokinetics and technique of endotracheal and deep endobronchial lidocaine administration. Anesth Analg. 1993;77:985-9.

Sagheer AS, Iqbal M, Ali K. Effect of Intracuff Lignocaine on Coughing during Emergence and Postoperative Sore Throat. Pakistan J Med Health Sci. 2009;3:1.

Camporesi EM, Mortola JP, Ambrogio SF, Ambrogio SG. Topical anesthesia of tracheal receptors. J Appl Physiol. 1979;47:1123-6.

Sconzo JM, Moscicki JC, Fazio DCA. In vitro diffusion of lidocaine across endotracheal tube cuffs. Reg Anesth. 1990;15:37-40.

Hirota W, Kobayashi W, Igarashi K. Lidocaine added to a tracheostomy tube cuff reduces tube discomfort. Canadian J Anesthesia J Canadiend Anesthesie. 2000;47:414.

Combes X, Schauvliege F, Peyrouset O. Intra-cuff pressure and tracheal morbidity: Influence of filling cuff with saline during nitrous oxide anesthesia. Anesthesiology. 2001;95:1120.

Altintas F, Bozkurt P, Kaya G, Akkan G. Lidocaine 10% in the endotracheal tube cuff: blood concentrations, haemodynamic and clinical effects. European J Anaesthesiology. 2000;17:436-42.

Navarro LH, Braz JR, Nakamura G, Lima RM, Silva Fde P, Modolo NS. Effectiveness and safety of endotracheal tube cuffs ﬁlled with air versus ﬁlled with alkalinized lidocaine: a randomized clinical trial. Sao Paulo Med J. 2007;125(6):322-8.

Herlevsen P, Bredahl C, Hindsholm K, Kruhoffer P. Prophylactic laryngo-tracheal aerosolized lidocaine against postoperative sore throat. Acta Anaesthesiol Scand. 1992;36:505-7.

Fagan C, Friesel HP, Laffey J, Hannon V, Carey M. The effects of intra-cuff lidocaine on endo-tracheal tube induced emergence phenomena after general anesthesia. Anesth Analg. 2000;91(1):201-5.