EVALUATION OF EFFECTIVENESS OF INTRACUFF ALKALINIZED LIDOCAINE FOR ATTENUATION OF ENDOTRACHEAL TUBEINDUCED COUGHING AND HAEMODYNAMIC CHANGES DURING EMERGENCE FROM GENERAL ANAESTHESIA.

  • Ignatius Chinedu Madu National Postgrduate Medical College of Nigeria (NPMCN)

Abstract

Background: Coughing and haemodynamic changes occurs frequently during emergence from general anesthesia with endotracheal intubation. Several methods have been used to attenuate them with various setbacks. Little is known about the use of alkalinized intracuff lidocaine for this purpose in the subSaharan region. Objective: The aim of this study was to determine the effects of alkalinized intracuff lidocaine on ETT induced coughing and haemodynamic changes at emergence from general anaesthesia. Methodology: Two hundred healthy patients with the American Society of Anaesthesiologist (ASA) physical status I and II scheduled for elective surgery under general anaesthesia with endotracheal intubation were studied. Patients belonged to one of four groups (50 patients/group) depending on whether air, saline, 40mg plain lidocaine or 40mg alkalinized lidocaine was used to inflate their high volume low pressure ETT cuff at intubation. At extubation the incidence of coughing and HR (heart rate), SBP (systolic blood pressure), DBP (diastolic blood pressure), MAP (mean arterial blood pressure) values were recorded over time. Presence of sore throat was assessed at recovery room and 24 hours later in the ward. RESULT: The incidence of coughing and sore throat assessed in the recovery room was least in the alkalinized lidocaine group, 30% and 16% respectively. Comparison among the 4 groups showed significant difference. P<0.05. Significant changes in HR, SBP, DBP, and MAP from baseline values occurred in all the groups overtime post extubation. However whereas there was an increase in these haemodynamic parameters in the first 4 minutes in air, saline, plain lidocaine groups, in the alkalinized lidocaine group there were either a decrease or no difference in the values. Conclusion: The use of alkalinized intracuff lidocaine resulted in a decrease in the incidence of coughing, sore throat and haemodynamic changes at emergence from general anaesthesia.

Published
2019-04-01
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