The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers
Revista Da Associação Médica Brasileira
The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers
Autor Correspondente: Laís Helena Camacho Navarro | [email protected]
Palavras-chave: Smoking, lidocaine, cough, hoarseness, nitrous oxide.
Resumos Cadastrados
Resumo Inglês:
Objective: We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine
was superior to saline in blunting emergence coughing, postoperative sore throat,
and hoarseness in smokers. Methods: In our prospective, double-blind trial, we enrolled
50 smoking patients undergoing surgery under general anesthesia including nitrous oxide
(N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine
plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The
ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive
pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were
analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia,
the time elapsed to extubation after discontinuation of anesthesia, and the volume
of the inflation solution and the air withdrawn from the ETT cuff were also recorded.
Results: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence
coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group
at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation,
sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness
was similar in both groups. Intracuff pressure in the saline group increased with time
while the intracuff pressure in the lidocaine group remained constant. Conclusion: The
present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to
saline in decreasing the incidence of emergence coughing and sore throat during the
postoperative period in smokers.
