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Comparison of Effectiveness Between the Combination of Lidocaine Sprayed at Laryngeal Inlet and on the Cuff of Endotracheal Tube Versus Intravenous Lidocaine for Reducing Cough During Extubation

Not Applicable
Completed
Conditions
Reducing Cough During Extubation
Interventions
Registration Number
NCT04090112
Lead Sponsor
Khon Kaen University
Brief Summary

Coughing during extubation of endotracheal tube (ETT) is a common problem that leads to poor surgical results including hemodynamic change, rebleeding at the surgical wound and wound dehiscence. Recently, lidocaine has been introduced for reducing coughing during extubation. However, data comparing routes of lidocaine application are lacking, thus, this study compared the combination of lidocaine sprayed on laryngeal inlet and cuff of ETT versus intravenous lidocaine injection for efficacy in reducing coughing

Detailed Description

A prospective randomized control trial was conduct with 164 patients. They were randomly allocated into Gr. A and B. Group A received four puffs of 10% lidocaine sprayed at the cuff of ETT and four puffs at laryngeal inlet whereas Gr. B received 15 mg/kg of 2% lidocaine intravenous injection prior to extubation. The same general anesthesia protocol was applied in all of the patients. Incidence and severity of cough during extubation was evaluated. Furthermore, incidence of 24-hour postoperative adverse events (including sore throat, dysphagia, and hoarseness) and hemodynamic response after extubation were analyzed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
164
Inclusion Criteria
  • patients who underwent elective surgery with American Society of Anesthesiologists physical status classifications of I and III
Exclusion Criteria
  • patients having body mass index more than 35 kg/m2, high risk of aspiration, chronic smokers more than ten pack-years, chronic cough or recent upper respiratory infection, suspected difficult airway, retained ETT prior surgery, surgery at oral cavity, neck and thoracic region, operative time more than 120 minutes or less than 30 minutes, and history of lidocaine allergy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
the study group (Group A)10% lidocaine sprayedPatients received four puffs of 10% lidocaine sprayed at the cuff of ETT and four puffs at laryngeal inlet
Comparator group (Group B)2% lidocaine intravenousPatients received 15 mg/kg of 2% lidocaine intravenous injection prior to extubation
Primary Outcome Measures
NameTimeMethod
Change in incidence of coughingthe incidence was recorded during extubation and immediatly extubation

Coughing event was recorded by blinded anesthesiologist

Secondary Outcome Measures
NameTimeMethod
Severity of coughingthe severity was recorded during extubation and immediatly extubation

the severity of cough was recorded by blinded anesthesiologist. Coughing level severity (16) was evaluated as 0 = no cough; 1 = slight cough, cough without obvious contraction of abdomen; 2 = moderate cough, strong and sudden contraction of the abdomen lasting less than 5 seconds; 3 = severe cough, strong and sudden contraction of the abdomen sustained more than 5 seconds

Incidence of postoperative sore throatthe incidence was recorded within 24 hr after extubation

Incidence of postoperative sore throat was recorded by two blinded anesthetist nurses . The numeric rating scale (0 = no, 10 = extreme) was used for evaluation of sore throat. If the numeric rating scale was more than 3, it was considered as a significant adverse event.

Incidence of dysphoniathe incidence was recorded within 24 hr after extubation

Incidence of dysphonia was recorded by two blinded anesthetist nurses .

Incidence of dysphagiathe incidence was recorded within 24 hr after extubation

Incidence of dysphagia was recorded by two blinded anesthetist nurses .

Trial Locations

Locations (1)

Khon Kaen University

🇹🇭

Khon Kaen, Thailand

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