EVALUATION OF INTRACUFF LIDOCAINE VERSUS ADDITION OF SODIUM BICARBONATE TO LIDOCAINE ON PREVENTION OF ENDOTRACHEAL TUBE INDUCED EMERGENCE PHENOMENA

Summary and ConclusionCoughing during emergence from general anaesthesia is common clinical problem. We sought to evaluate the effect of filling an endotracheal tube cuff with 40 mg lidocaine alone (group II) or alkalinized lidocaine (group III) in comparison to air control group (group I) on adverse emergence phenomena in a randomized controlled study (n = 20 in each group). A total of sixty patients undergoing elective surgery expected to last more than one hour were included in the study. We exclude cases of difficult intubation and patient with a physical status more than ASA II.After intubation of the trachea with an ETT, the cuff of the tube was inflated according to the randomization of the groups and the injected volumes were recorded in each group. Patients in all groups received the same anaesthetic technique. The preoperative haemodynamic indices were recorded for patients in all groups. At extubation, the volume removed from the cuff of the tube and the spontaneous ventilation time were also estimated. The incidence of cough, sore throat, hoarseness, laryngospasm and postoperative nausea and vomiting were recorded by a blind observer. Also, the emergence haemodynamic indices were recorded.All haemodynamic data during the extubation period decreased than preoperative data in liquid groups (group II and III) and the decrease was more in group III compared with group II. Also, all tube-induced-emergence phenomena decreased in group III and II compared in group I with better tolerance to the tube was recorded with group III compared with group II.ConclusionWe concluded that the use of intracuff lidocaine can reduce the incidence of ETT emergence phenomena, this effect can be improved by addition of NaHCO3 to lidocaine.