Comparison of intracuff 2% lidocaine and dexamethasone on post-extubation reactions
Article Sidebar
Main Article Content
Abstract
This study compared the effects of intracuff 2% lidocaine and dexamethasone to decrease the severity of post-extubation reactions in terms of sore throat, hoarseness, dysphagia and patient satisfication after general anesthesia. Design of this study was a prospective randomized controlled trial. Ninety three patients were randomly allocated into the groups of lidocaine, dexamethasone and normal saline to fill the endotracheal tube (ETT) cuff. Four-leveled score of sore throat, hoarseness and dysphagia at 1 and 24 hours and 5-leveled satisfication score at 24 hours post-extubation were evaluated. The results showed that patients in the lidocaine group had significantly less symptoms of sore throat than the two groups at 1 hour (P=0.001). At 24-hour, the lidocaine and dexamethasone groups had significantly less symptoms of sore throat than the normal saline group (p<0.001 and p=0.006 respectively) and the lidocaine group had less dysphagia and hoareness than the other two groups (P<0.05). No significant difference was detected for patient satisfication scores between the three groups at 24 hours post-extubation. Compared to dexamethasone, intracuff lidocaine can more lessen sore throat symptoms at 1-hour post-extubation, hoarseness and dysphagia at 24 hours post-extubation.
Article Details
References
2. Biro P, Seifert B, Pasch T. Complaints of sore throat after tracheal intubation: a prospective evaluation. Eur J Anaesthesiol 2005; 22: 307-11.
3. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth 2002; 88: 582-4.
4. Maruyama K, Sakai H, Miyazawa H, Toda N, Iinuma Y, Mochizuki N, et al. Sore throat and hoarseness after total intravenous anaesthesia.Br J Anaesth 2004; 92: 541-3.
5. Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad 2007; 19: 12-4.
6. Hisham AN, Roshilla H, Amri N, Aina EN. Postthyroidectomy sore throat following endotracheal intubation. ANZ J Surg 2001; 71: 669-71.
7.Singh M, Malhotra N, Malhotra S. Tracheal morbidity following tracheal intubation: Comparison of air, saline and lignocaine used for inflating cuff. J Anaesthesiol Clin Pharmacol. 2007;23(2):163–7.
8. Chen KT, Tzeng JI, Lu CL, Liu KS, Chen YW, Hsu CS, et al. Risk factors associated with postoperative sore throat after tracheal intubation: an evaluation in the postanesthetic recovery room. Acta Anaesthesiol Taiwan 2004; 42: 3-8.
9. Stanley TH, Kawamura R, Graves C. Effects of nitrous oxide on volume and pressure of endotracheal tube cuffs. Anesthesiology 1974; 11: 256-61.
10. Bahk JH, Lim YJ. Use of intracuff lidocaine during general anesthesia. Anesth Analg. 2001;92(4):1075.
11. Bennett MH, Isert PR, cumming RG. Postoperative sore throat and hoarseness following tracheal intubation using air or saline to inflate the cuff-a randomized controlled trial. Anaesth Intensive Care 2000; 28:408-13.
12. Tanaka Y, Nakayama T, Nishimori M, Sato Y, Furuya H. Lidocaine for preventing postoperative sore throat. Cochrane Database Syst Rev. 2009;(3):CD004081.
13. Thomas S, Beevi S. Dexamethasone reduces the severity of postoperative sore throat. Can J Anaesth. 2007;54(11):897–901.
14.Brandt L, Pokar H. The rediffusion system. Limitation of nitrous oxide increases the cuff pressure of endotracheal tube. Anaesthesist 1983; 32:459-64.
15. Nguyen TH, Saidi N, Lieutaud T, Bensaid S, Menival V, Duvaldestin P. Nitrous oxide increases endotracheal cuff pressure and the incidence of tracheal lesions in anesthetized patients. Anesth Analg 1999; 89:187-90.
16.Fagan C, Frizelle HP, Laffey J, Hannon V , Carey M. The effects of intracuff lidocaine on endotrachealtube-induced emergence phenomena after general anesthesia. Anesth Analg. 2000;91(1):201–5.