Introduction: Although inflating tracheal cuff using lidocaine is effective for cough suppression, it may pressure tracheal cuff too much. Intravenous continuous infusion of lidocaine has emerged recently for most general anesthesia in the context of opioid-sparing anesthesia for cancer, but the 95% effective dose (ED95) for cough suppression during anesthesia emergence is not determined yet. Objective: the objectives of this study are to determine the ED95 of continuous infusion lidocaine for suppressing cough reflex during extubation by sex and age group.
Ideal patient weight in kg will be considered. Initial dose will be 0.5mg/kg.h and dose-change steps of 0.5mg/kg.h will occur depending on the incidence of emergence cough in the previous patient of the same group: * It will increase if coughed in a probability of 95% * It will decrease if not coughed in a probability of 5%. * It will remain the same otherwise. Maximum dose will be 3mg/kg.h. All patients will receive remifentanil 0.025mcg/kg.min continuous infusion until extubation. Patients groups will be determined by sex and age group (18-60 or \>60 years old), therefore, four independent groups will be studied: * Female 18 to 60 years old * Male 18 to 60 years old * Female \> 60 years old * Male \> 60 years old
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
132
Continuous infusion, variable dose of lidocaine.
Hospital Universitario de Brasilia
Brasília, Federal District, Brazil
RECRUITINGCough during anesthesia emergence
Dichotomic variable, true if any cough is detected from anesthesia weaning to extubation.
Time frame: Anytime during anesthesia emergence, before extubation.
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