The application of lidocaine cream on oral secretions of LMA removal during the recovery period in ophthalmic surgical patients under general anesthesia: a randomized controlled trial
During the recovery from general anesthesia, patients commonly experience heightened oral secretions, which can elevate intraocular pressure (IOP) due to coughing and potentially lead to the infiltration of secretions into the surgical site via the nasolacrimal duct, increasing the risk of endophthalmitis. This study is aimed to investigate whether applying lidocaine cream to the laryngeal mask airway (LMA) reduces oral secretions during emergence from general anesthesia in ophthalmic surgery patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Group U receives 1 mL of lidocaine cream extracted using a syringe and evenly applied across the entire posterior surface of the LMA cuff by carefully spreading the cream to ensure uniform coverage, while Group N receives 1 mL of lidocaine cream also extracted using a syringe but applied without ensuring even distribution, resulting in a patchy or non-uniform application.
No lidocaine cream will be applied to the LMA
The volume of oral secretions
Oral secretions will be collected during the phase of anesthesia emergence. In the PACU, oral and nasopharyngeal secretions are gently suctioned using a negative pressure aspirator during the phase of emergence. Subsequently, 50 ml of normal saline is used to flush the suction tubing. The volume of oral secretions (ml) is calculated as the total volume in the suction canister minus 50 ml.
Time frame: Assessed during the phase of anesthesia emergence, from the discontinuation of anesthetic agents to eye opening or purposeful movement; and reported up to 4 weeks.
The time completion of LMA insertion
Time frame: Assessed from holding the airway tube to successful insertion of the LMA; and reported up to 4 weeks.
Oropharyngeal leak pressure (OLP)
OLP is measured by setting the expiratory valve to 30 cmH2O at a gas flow rate of 3 L/min, recording the maximum inflation pressure when a noise of gas leakage is heard in the oropharynx via a stethoscope
Time frame: Assessed after the completion of LMA insertion; and reported up to 4 weeks.
Time to LMA removal
Time frame: Assessed from discontinuation of anesthetic agents to LMA removal; and reported up to 4 weeks.
Time to emergence
Time frame: Assessed from the discontinuation of anesthetic agents to eye opening or purposeful movement; and reported up to 4 weeks.
PACU recovery time
Time frame: Assessed from arrival in the PACU until the modified Aldrete score achieved at least 9; and reported up to 4 weeks.
Postoperative airway complications
Postoperative airway complications, including coughing, laryngospasm, or blood on device, will be recorded at the time of LMA removal
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Time frame: Assessed at the time of LMA removal; and reported up to 4 weeks.
Pharyngeal complications
Pharyngeal complications, such as sore throat, dysphagia, or hoarseness, will be collected
Time frame: Assessed at 1 h and 24 h postoperatively; and reported up to 4 weeks.
The level of sore throat
The level of sore throat will be graded as follows: none, no sore throat; mild, pain with deglutition; moderate, pain constantly present and increasing with deglutition; severe, pain interfering with eating and requiring analgesic medication
Time frame: Assessed at 1 h and 24 h postoperatively; and reported up to 4 weeks.
Ocular and other complications
Time frame: Assessed within 48 h after the surgery; and reported up to 4 weeks.