2. Registrar, Department of Anaesthesiology, Yashoda Hospital, Somajiguda, Hyderabad, India.
3. Fellow National Boards, Department of Anaesthesiology, Yashoda Hospital, Somajiguda, Hyderabad, India.
4. Senior consultant, Department of Anaesthesiology, Yashoda Hospital, Somajiguda, Hyderabad, India.
Background: Endotracheal intubation for airway management in general anaesthesia is associated with post intubation morbidities due to prolonged inflation of the ETT cuff. Many studies have used Lidocaine by instillation in the ETT cuff and its diffusion to the underlying tracheal mucosa there by reducing local irritation and inflammation of the airway.
Aims: To study the favorable effects of lidocaine(4%)instillation in the endotracheal tube cuff in surgical patients as compared to air.
Settings and design: The study was done in a multispeciality teaching hospital. Eighty patients were selected and randomly divided into two groups.
Methods and Material: Eighty patients of ASA – I & II status posted for general surgery were randomly selected and divided into two groups after randomization.All these general surgeries lasted for duration of 30-45 minutes. Blood loss intraop.was around 200-300ml only. All these patients received first dose of I.V.fentanyl for analgesia at induction. In forty patients air was filled in ETT cuff and in remaining patients lidocaine (4%) 3-5ml was instilled keeping the cuff pressure between 20-22mmHg. Coughing and hemodynamic parameters were noted at and after extubation. Intubation related morbidities were compared between the two groups. Patients with hypertension, COPD, recurrent respiratory infections etc. and those needing postop ventilator supports were excluded.
Statistical analysis used: The database of all parameters were analysed using "STATA SOFTWARE VERSION10.0".
Results: The study showed a significant difference in the incidence of post-operative sore throat in group I(air) and group II (lidocaine). Lidocaine group had lesser sore throat incidence. There was no significant change in heart rate initially but showed a significant change in both the study groups at later intervals. Similarly there was a highly significant change in blood pressure in both the study groups at 2, 5, 10, 30 and 60 min after extubation.
Conclusions: Lidocaine can be used for instillation in ETT cuff to minimize the postintubation morbidities.
Keywords: Lidocaine 4%, endotracheal tube cuff instillation, postintubation morbidity