A prospective randomized trial on alkalinized lignocaine preloaded endotracheal tube cuffs to reduce emergence cough following brief surgery
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 1053-1058
AbstractBackground and Objectives: Endotracheal intubation is required during general anaesthesia to secure the airway. Presumed mechanisms for emergence cough include irritant or stretching sensations in the trachea brought on by the tube or its cuff. Cough during emergence results in Hypertension, tachycardia, raised Intracranial pressure and intraocular pressure, bronchospasm, wound dehiscence, and surgical bleeding. Our goal is to determine whether alkalinized lignocaine preloaded endotracheal tube cuffs are effective at reducing emergence cough following minor surgery.
Methods: After receiving approval from the institutional ethics committee, this prospective randomised controlled study was carried out on ASA grade I and II patients between the ages of 20 and 50 who were scheduled for a variety of short-duration surgeries under general anaesthesia at Mamata General Hospital for a period of one year. Total of 100 patients, are divided into two groups, Group AL, Group S (50 patients in each Group). Group AL: (study group) these patients received preloaded (alkalinised lignocaine in ET cuff 90 min before intubation) 2% alkalinised lignocaine in the ET cuff, volume decided by minimum occlusion volume technique. Group S: (control group): these patients received normal saline in ET cuff after intubation.
Results: Patients in AL Group had mild cough in 12% of the population, while Patients in S group had mild cough in 14%, moderate cough in 10% and severe cough in 4% of the group population. Emergence cough is significantly less in AL group compared to S Group (p=0.39).
Conclusion: Alkalinized lidocaine in ETTs preloaded with the same solution before surgery appears to significantly lower the incidence of emergence cough during short surgical procedures. Also reduces emergence agitation and provides hemodynamic stability during extubation by avoiding the pressor response.
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