Coughing during extubation of endotracheal tube (ETT) is a common problem that leads to poor surgical results including hemodynamic change, rebleeding at the surgical wound and wound dehiscence. Recently, lidocaine has been introduced for reducing coughing during extubation. However, data comparing routes of lidocaine application are lacking, thus, this study compared the combination of lidocaine sprayed on laryngeal inlet and cuff of ETT versus intravenous lidocaine injection for efficacy in reducing coughing
A prospective randomized control trial was conduct with 164 patients. They were randomly allocated into Gr. A and B. Group A received four puffs of 10% lidocaine sprayed at the cuff of ETT and four puffs at laryngeal inlet whereas Gr. B received 15 mg/kg of 2% lidocaine intravenous injection prior to extubation. The same general anesthesia protocol was applied in all of the patients. Incidence and severity of cough during extubation was evaluated. Furthermore, incidence of 24-hour postoperative adverse events (including sore throat, dysphagia, and hoarseness) and hemodynamic response after extubation were analyzed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
164
four puffs of 10% lidocaine sprayed at the cuff of ETT and four puffs at laryngeal inlet
15 mg/kg of 2% lidocaine intravenous injection prior to extubation
Khon Kaen University
Khon Kaen, Thailand
Change in incidence of coughing
Coughing event was recorded by blinded anesthesiologist
Time frame: the incidence was recorded during extubation and immediatly extubation
Severity of coughing
the severity of cough was recorded by blinded anesthesiologist. Coughing level severity (16) was evaluated as 0 = no cough; 1 = slight cough, cough without obvious contraction of abdomen; 2 = moderate cough, strong and sudden contraction of the abdomen lasting less than 5 seconds; 3 = severe cough, strong and sudden contraction of the abdomen sustained more than 5 seconds
Time frame: the severity was recorded during extubation and immediatly extubation
Incidence of postoperative sore throat
Incidence of postoperative sore throat was recorded by two blinded anesthetist nurses . The numeric rating scale (0 = no, 10 = extreme) was used for evaluation of sore throat. If the numeric rating scale was more than 3, it was considered as a significant adverse event.
Time frame: the incidence was recorded within 24 hr after extubation
Incidence of dysphonia
Incidence of dysphonia was recorded by two blinded anesthetist nurses .
Time frame: the incidence was recorded within 24 hr after extubation
Incidence of dysphagia
Incidence of dysphagia was recorded by two blinded anesthetist nurses .
Time frame: the incidence was recorded within 24 hr after extubation
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