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A Comparative Study of Inflation of Endotracheal Tube Cuff with Buffered Lidocaine, Saline and Air for Smooth Periextubation Period in Patient with Hyperactive Airway

B.L. Sharma* , B.L. Sharma* , Rajesh Sharma**

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Indian Journal of Anesthesia and Analgesia 4(1):p 25-32, January - March 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4117.4

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Abstract

 Background: Increased cough and restlessness during emergence from general anaesthesia in patients with hyperactive airway undergoing surgical procedures might result in adverse effects like hypertension, tachycardia or tachy arrhythmias, myocardial ischaemia, bronchospasm, and increased bleeding at the surgical site. Hence, in such patients, we sought to determine the benefits of filling the endotracheal tube cuff with either buffered lidocaine, saline or air, so as to prevent endotracheal tube­induced coughing during emergence from general anaesthesia. Aim and Objectives: To compare effects of ETT cuff inflation with buffered lidocaine 2%, saline and air for peri extubation period in patients with hyperactive airway for Initial & final ETT cuff pressure difference, Occurrence of cough in periextubation period & Incidence of sore throat post operatively. Method: 240 patients of ASA grade 1 & 2, of 15 to 60 years old, either with a history of chronic smoking or recently treated upper respiratory tract infections were randomly assigned into three groups (n = 80), based on the type of endotracheal tube cuff inflation, as follows: Group A (air), Group B (normal saline) and Group C (Buffered lidocaine). Cough in periextubation period was graded at extubation as: Grade 0 (no cough), Grade 1 (cough < 15s) and Grade 2 (cough > 15s). Result: Extubation was smooth in Group C compared with Groups B and A (p < 0.0001). Further, the incidence of sore throat was found to be lower in both liquid groups, B and C, compared with Group A at 1 h (p < 0.0001) and 24 h (p < 0.01) postoperatively.

Keywords: Buffered Lignocaine; Hyperactive Airway; Periextubation Period; Endotracheal Tube Cuff.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4117.4

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