Evaluation and Comparison of the Effects of Intravenous Lidocaine versus Alkalinized Intracuff Lidocaine on Coughing and Postoperative Sore Throat

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Coughing and sore throat are among the most common complications of intubation. Variety of drugs have been experimented to reduce these complications, but the information in this regard is limited and controversial. The current study compared intracuff alkalinized lidocaine, intravenous lidocaine, and a control group.Methods: This was a randomized controlled double-blinded clinical trial study on 99 patients undergoing intubation. Patients were randomly divided into three equal groups, intracuff alkalinized lidocaine, intravenous lidocaine, and control group, in them, the cuff was filled with air till pressure reached under 30 cmH2O. Cough frequency and sore throat severity were assessed and compared based on visual analog scale (VAS) immediately after extubation, and within 15 minutes, 1, 2, 3, 12, and 24 hours after extubation.Findings: Comparison of sore throat among 3 groups in different times showed no difference (P > 0.050); but within 24 hours decreased in all three groups of intracuff alkalinized lidocaine (P < 0.001), intravenous lidocaine (P < 0.001), and control (P = 0.001). Sore throat severity decreased significantly in all three groups during a period of 24 hours (P < 0.050). Comparison of cough frequency immediately after extubation (P = 0.005) and within 24 hours (P = 0.007) was significantly less in intracuff alkalinized lidocaine group. Within 24 hours, the frequency of coughing decreased significantly in all three groups of intracuff alkalinized lidocaine (P = 0.040), intravenous lidocaine (P = 0.001), and control (P = 0.002).Conclusion: Based on the current study, there was no difference among alkalinized intracuff lidocaine, intravenous lidocaine, and control group in the reduction of sore throat, but to reduce cough, alkalinized lidocaine was significantly influential.

Keywords

References

  1. Soltani HA, Aghadavoudi O. The effect of different lidocaine application methods on postoperative cough and sore throat. J Clin Anesth 2002; 14(1): 15-8.
  2. Tabari M, Soltani G, Zirak N, Alipour M, Khazaeni K. Comparison of effectiveness of betamethasone gel applied to the tracheal tube and IV dexamethasone on postoperative sore throat: A randomized controlled trial. Iran J Otorhinolaryngol 2013; 25(73): 215-20.
  3. Solatpour F, Teymourian H, Mohajerani SA, Hoseinzadegan SF, Lotfollah ZS, Baikpour M, et al. Comparison of the incidence of sore throat after rapid sequence intubation with succinylcholine and cisatracurium. Anesth Pain Med 2014; 4(3): e20030.
  4. Kumar CA, Kumar DS. Prevention of post intubation sore throat by using analkalinized lignocaine filled ETT cuff. Int J Intg Med Sci2018;5(7):693-699.
  5. Park JT, Lim HK, Jang KY, Um DJ. The effects of desflurane and sevoflurane on the intraocular pressure associated with endotracheal intubation in pediatric ophthalmic surgery. Korean J Anesthesiol 2013; 64(2): 117-21.
  6. Sitzman BT, Rich GF, Rockwell JJ, Leisure GS, Durieux ME, DiFazio CA. Local anesthetic administration for awake direct laryngoscopy. Are glossopharyngeal nerve blocks superior? Anesthesiology 1997; 86(1): 34-40.
  7. Chari V, Paul A. Comparative study to analyze the incidence of sore throat, cough, and hoarseness of voice after general anesthesia with the use of topical benzydamine hydrochloride and 2% lignocaine gel with placebo. Med J DY Patil Univ 2016; 9(1): 61-5.
  8. Estebe JP, Delahaye S, Le Corre P, Dollo G, Le Naoures A, Chevanne F, et al. Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena. Br J Anaesth 2004; 92(3): 361-6.
  9. Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad 2007; 19(2): 12-4.
  10. Kazemi A, Amini A. The effect of betamethasone gel in reducing sore throat, cough, and hoarseness after laryngo-tracheal intubation. Middle East J Anaesthesiol 2007; 19(1): 197-204.
  11. Charan SD, Khilji MY, Jain R, Devra V, Saxena M. Inhalation of ketamine in different doses to decrease the severity of postoperative sore throat in surgeries under general anesthesia patients. Anesth Essays Res 2018; 12(3): 625-9.
  12. Estebe JP, Dollo G, Le Corre P, Le Naoures A, Chevanne F, Le VR, et al. Alkalinization of intracuff lidocaine improves endotracheal tube-induced emergence phenomena. Anesth Analg 2002; 94(1): 227-30.
  13. Jain S, Barasker SK. A comparative study of preoperative ketamine and MgSO4 nebulisation for incidence of post operative sore throat after endotracheal intubation. Int J Contemp Med Res 2017; 4: 1356-9.
  14. Suzuki N, Kooguchi K, Mizobe T, Hirose M, Takano Y, Tanaka Y. Postoperative hoarseness and sore throat after tracheal intubation: Effect of a low intracuff pressure of endotracheal tube and the usefulness of cuff pressure indicator. Masui 1999; 48(10): 1091-5. [In Japanese].
  15. Teoh SC, Lee CY. Comparison between lignocaine 2% gel and water-based lubricant in reducing post intubation sore throat. Brunei International Medical Journal 2014; 10(2): 85-91.
  16. Banihashem N, Alijanpour E, Hasannasab B, Zarei A. Prophylactic effects of lidocaine or beclomethasone spray on post-operative sore throat and cough after orotracheal intubation. Iran J Otorhinolaryngol 2015; 27(80): 179-84.
  17. Navarro LH, Lima RM, Aguiar AS, Braz JR, Carness JM, Modolo NS. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers. Rev Assoc Med Bras (1992) 2012; 58(2): 248-53.
  18. Xu YJ, Wang SL, Ren Y, Zhu Y, Tan ZM. A smaller endotracheal tube combined with intravenous lidocaine decreases post-operative sore throat - a randomized controlled trial. Acta Anaesthesiol Scand 2012; 56(10): 1314-20.
  19. Huang CJ, Hsu YW, Chen CC, Ko YP, Rau RH, Wu KH, et al. Prevention of coughing induced by endotracheal tube during emergence from general anesthesia--a comparison between three different regimens of lidocaine filled in the endotracheal tube cuff. Acta Anaesthesiol Sin 1998; 36(2): 81-6.
  20. Nath P, Williams S, Herrera Mendez LF, Massicotte N, Girard F, Ruel M. Alkalinized lidocaine preloaded endotracheal tube cuffs reduce emergence cough after brief surgery: A prospective randomized trial. Anesth Analg 2018; 126(2): 615-20.
  21. Souissi H, Frechette Y, Murza A, Masse MH, Marsault E, Sarret P, et al. Intracuff 160 mg alkalinized lidocaine reduces cough upon emergence from N2O-free general anesthesia: A randomized controlled trial. Can J Anaesth 2016; 63(7): 862-70.
  22. Vandse R, Castellon-Larios K, Fujii J, Melibary S, Wei L, Nashed S, et al. Randomized double blind control study comparing the efficacy of intracuff alkalinized lidocaine to low dose remifentanil infusion in attenuating the endotracheal tube induced emergence phenomena. J Anesth Clin Res 2014; 5(9): 435.
Journal of Isfahan Medical School
Volume 36, Issue 510 - Serial Number 510
November and December 2019
Pages 1584-1590

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History

  • Receive Date: 23 August 2018
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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