Effect of alkalinized lidocaine versus air as intracuff inflating agent in general anaesthesia: a comparative study

Abstract

Background: Post-operative sore throat, cough and hoarseness of voice are undesired and neglected occurrences after general anaesthesia with endotracheal intubation. Tracheal intubation results in stretch stimuli in the trachea caused by the tube and its cuff. Targeted delivery of lidocaine to the mucosa in contact with the tracheal tube (ETT) cuff can be used as a method for decreasing tracheal stimuli. Methods: This study is a randomized controlled trial. A total of 60 Patients who underwent elective surgical procedures under general anaesthesia at ShSMCH Dhaka were included in this study. They were randomized into two groups; group A and group L. In group A, (n = 30) air was used to fill the endotracheal tube cuff. In group L, (n = 30) 2% lidocaine (3-5) ml with 7.5% NaHCO3 (2-3) ml was used to fill the endotracheal tube cuff. Chi –Square test with Yates correction was used to analyze the categorical variables, shown with cross tabulation. Student t-test was used for continuous variables. P values <0.05 was considered as statistically significant. Postoperatively, patients were directly asked about the presence of sore throat, cough and hoarseness of voice at two intervals; 1 to 3 hours and 22 to 24 hours. Results: Both the groups were comparable with regard to age, gender, height, weight and ASA physical status. The mean duration of operation and mean duration of anaesthesia were found statistically non-significant (p>0.05) between two groups. At the end of surgery, mean cuff pressure was found 24.3±2.1 cmH2O in group A and 22.9±1.8 cmH2O in group L, which was statistically significant (p<0.05) between two groups. Seven (23.3%) patients had sore throat after 1-3 hours in group A and 2(6.7%) in group L. Eleven (36.7%) patients had sore throat after 22-24 hours in group A and 3(10.0%) in group L. Sore throat after 22-24 hours was statistically significant (p<0.05) between two groups. Eight (26.7%) patients had cough after 1-3 hours in group A and 3(10.0%) in group L. Twelve (40.0%) patients had cough after 22-24 hours in group A and 4(13.3%) in group L. Cough after 22-24 hours was statistically significant (p<0.05) between two groups. Fifteen (50.0%) patients had hoarseness after 1-3 hours in group A and 7(23.3%) in group L. Eight (26.7%) patients had hoarseness after 22-24 hours in group A and 2(6.7%) in group L. The difference wasstatistically significant (p<0.05) between two groups. Conclusion: Our study shows that sore throat, cough and hoarseness were significantly decreased in postoperative period by using ETT cuff inflated with 2% alkalinized lidocaine better than cuff inflated with air.

JBSA 2023; 36 (1) : 16-21