Comparison of Tracheal Extubation Comfort between Two Endotracheal Tube Filling in Laparoscopic Cholecystectomy
Journal of Cellular & Molecular Anesthesia,
Vol. 4 No. 4 (2019),
24 March 2020
AbstractBackground: Post-intubation airway complications such as cough and sore throat are common complaints after anesthesia. After intubation, filling the endotracheal tube will close the tube space and stimulate the endotracheal tube. It is used to fill the cuff with air or liquids such as normal saline, lidocaine, etc. The purpose of this study was to compare the comfort of tracheal extubation between the two methods of filling the tracheal cuff with lidocaine 2% and filling with air in patients undergoing laparoscopic cholecystectomy.Methods and materials: In this single-blind clinical trial study, 70 patients were randomly divided into two groups of air and lidocaine. In the lidocaine group, the endotracheal tube cuff was filled with 2% lidocaine and in the air cuff group the cuff pressure reached 20 to 25 cm of water. Blood pressure and heart rate of patients before induction, after induction, 30 and 60 minutes after and before and after extubation, as well as complications of intubation including bucking, cough and sore throat during recovery, 6 hours and 12 hours later were compared. Data were analyzed using SPSS software version 16.Results: The results of this study showed that there were no significant differences in heart rate at different intervals of the study including pre-induction, post-induction, 30 and 60 min, before and after extubation. But the systolic and diastolic blood pressure after extubation were significantly lower in the lidocaine group than in the air group, although at other intervals there was a significant difference between the two parameters in the study groups. After extubation, sore throat complications were significantly lower at all study intervals.Conclusion: According to the results of the same study, it seems that filling the cuff with lidocaine over the air leads to more hemodynamic stability and less side effects after extubation.
Keywords: Intubation, Lidocaine, Complications
How to Cite
Lapinsky SE. Endotracheal intubation in the ICU. Crit Care. 2015;19:258.
Alanazi A. Intubations and airway management: An overview of Hassles through third millennium. J Emerg Trauma Shock. 2015;8(2):99-107.
Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med. 1981;70(1):65-76.
Sollid SJ, Mellin-Olsen J, Wisborg T. Emergency airway management - by whom and how? Acta Anaesthesiol Scand. 2016;60(9):1185-7.
Knudsen K, Nilsson U, Högman M, Pöder U. Awake intubation creates feelings of being in a vulnerable situation but cared for in safe hands: a qualitative study. BMC Anesthesiol. 2015;16(1):71.
Loh KS, Irish JC. Traumatic complications of intubation and other airway management procedures. Anesthesiol Clin North Am. 2002;20(4):953-69
Cooper JD. Tracheal injuries complicating prolonged intubation and tracheostomy. Thorac Surg Clin. 2018;28(2):139-144.
Simons T, Söderlund T, Handolin L. Radiological evaluation of tube depth and complications of prehospital endotracheal intubation in pediatric trauma: a descriptive study. Eur J Trauma Emerg Surg. 2017;43(6):797-804.
Lee HY, Lu CH, Lu HF, Chen CL, Wang CH, Cheng KW, Wu SC, Jawan B, Huang CJ. Relationship between postoperative lung atelectasis and position of the endotracheal tube in pediatric living-donor liver transplantation. Transplant Proc. 2012;44(4):875-7.
Driver BE, Klein LR, Schick AL, Prekker ME, Reardon RF, Miner JR. The occurrence of aspiration pneumonia after emergency endotracheal intubation. Am J Emerg Med. 2018;36(2):193-6.
Jaber S, Amraoui J, Lefrant J-Y, Arich C, Cohendy R, Landreau L, Calvet Y, Capdevila X, Mahamat A, Eledjam JJ. Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Crit Care Med. 2006;34(9):2355-61.
Owen H, Waddell-Smith I. Dental trauma associated with anaesthesia. Anaesth Intensive Care. 2000;28(2):133-45.
Mańka-Malara K, Gawlak D, Hovhannisyan A, Klikowska M, Kostrzewa-Janicka J. Dental trauma prevention during endotracheal intubation—review of literature. Anaesthesiol Intensive Ther. 2015;47(4):425-9.
Joseph TT, Gal JS, DeMaria S Jr, Lin HM, Levine AI, Hyman JB. A Retrospective Study of Success, Failure, and Time Needed to Perform Awake Intubation. Anesthesiology. 2016;125(1):105-14.
Maggiore SM1, Lellouche F, Pignataro C, Girou E, Maitre B, Richard JC, Lemaire F, Brun-Buisson C, Brochard L. Decreasing the adverse effects of endotracheal suctioning during mechanical ventilation by changing practice. Respir Care. 2013;58(10):1588-97.
Pan Y, Song S, Tang X, Ai Q, Zhu D, Liu Z, Yu J. Streptococcus sp. in neonatal endotracheal tube biofilms is associated with ventilator-associated pneumonia and enhanced biofilm formation of Pseudomonas aeruginosa PAO1. Sci Rep. 2017;7(1):3423.
van Esch BF, Stegeman I, Smit AL. Comparison of laryngeal mask airway vs tracheal intubation: a systematic review on airway complications. J Clin Anesth. 2017;36:142-50.
Lilienstein JT, Davis JW, Bilello JF, Dirks RC. Risk factors associated with post-extubation stridor in the trauma intensive care unit. Am J Surg. 2016;212(3):379-83.
Kuriyama A, Umakoshi N, Sun R. Prophylactic corticosteroids for prevention of postextubation stridor and reintubation in adults: a systematic review and meta-analysis. Chest. 2017;151(5):1002-10.
Meyer, G p, Orliaguet G, Blanot S, Jarreau MM, Charron B, Sauverzac R, Carli P. Complications of emergency tracheal intubation in severely head‐injured children. Paediatr Anaesth. 2000;10(3):253-60.
Jiang JR, Yen SY, Chiang PF, Liu HC. Endotracheal tube size to leakage ventilation and tracheal dilatation. J Anesth. 2018;32(3):351-9.
Park HS, Kim HJ, Ro YJ, Yang HS, Koh WU. Delayed bilateral vocal cord paresis after a continuous interscalene brachial plexus block and endotracheal intubation: A lesson why we should use low concentrated local anesthetics for continuous blocks. Medicine (Baltimore). 2017;96(15):e6598.
Anderson JL. Current understanding of lidocaine as an antiarrhythmic agent: a review. Clinical therapeutics. 1984;6(2):125-41.
Weinberg L, Peake B, Tan C, Nikfarjam M. Pharmacokinetics and pharmacodynamics of lignocaine: a review. Clin Ther. 1984;6(2):125-41.
Zaric D, Pace NL. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Cochrane Database Syst Rev. 2009;(2):CD003006.
Mehra P, Caiazzo A, Maloney P. Lidocaine toxicity. Anesth Prog. 1998;45(1):38-41.
Sakles JC, Deacon JM, Bair AE, Keim SM, Panacek EA. Delayed complications of emergency airway management: a study of 533 emergency department intubations. West J Emerg Med. 2008;9(4):190-4.
Paraschiv M. Iatrogenic tracheobronchial rupture. J Med Life. 2014;7(3):343-8.
Evans DP, Lo BM. Uvular necrosis after orotracheal intubation. Am J Emerg Med. 2009;27(5):631.e3-4.
Auroy Y, Benhamou D, Péquignot F, Bovet M, Jougla E, Lienhart A. Mortality related to anaesthesia in France: analysis of deaths related to airway complications. Anaesthesia. 2009;64(4):366-70.
Ahmed A, Abbasi S, Ghafoor HB, Ishaq M. Postoperative sore throat after elective surgical procedures. J Ayub Med Coll Abbottabad. 2007;19(2):12-4.
Radu A, Miled F, Marret E, Vigneau A, Bonnet F. Pharyngo-laryngeal discomfort after breast surgery: comparison between orotracheal intubation and laryngeal mask. Breast. 2008;17(4):407-11.
Maruyama K, Sakai H, Miyazawa H, Iijima K, Toda N, Kawahara S, Hara K. Laryngotracheal application of lidocaine spray increases the incidence of postoperative sore throat after total intravenous anesthesia. Masui J Anesth. 2004;18(4):237-40.
Sumathi P, Shenoy T, Ambareesha M, Krishna H. Controlled comparison between betamethasone gel and lidocaine jelly applied over tracheal tube to reduce postoperative sore throat, cough, and hoarseness of voice. Br J Anaesth. 2008;100(2):215-8.
Crerar C, Weldon E, Salazar J, Gann K, Kelly JA, Pellegrini JE. Comparison of 2 laryngeal tracheal anesthesia techniques in reducing emergence phenomena. AANA J. 2008;76(6): 425-31.
Altintaş F1, Bozkurt P, Kaya G, Akkan G. Lidocaine 10% in the endotracheal tube cuff: blood concentrations, haemodynamic and clinical effects. Eur J Anaesthesiol. 2000;17(7):436-42.
Gaur P, Ubale P, Khadanga P. Efficacy and safety of using air versus alkalinized 2% lignocaine for inflating endotracheal tube cuff and its pressure effects on incidence of postoperative coughing and sore throat. Anesth Essays Res. 2017;11(4):1057-1063.
Soares SM, Arantes VM, Módolo MP, Dos Santos VJ, Vane LA, Navarro E Lima LH, Braz LG, do Nascimento P Jr, Módolo NS. The effects of tracheal tube cuffs filled with air, saline or alkalinised lidocaine on haemodynamic changes and laryngotracheal morbidity in children: a randomised, controlled trial. Anaesthesia. 2017;72(4):496-503.
Navarro RM, Baughman VL. Lidocaine in the endotracheal tube cuff reduces postoperative sore throat. J Clin Anesth. 1997;9(5):394-7.
Lam F, Lin YC, Tsai HC, Chen TL, Tam KW, Chen CY. Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One. 2015;10(8):e0136184.
Venkatesan T, Korula G. A comparative study between the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous lignocaine on coughing and hemodynamics during extubation in neurosurgical patients: a randomized controlled double-blind trial. J Neurosurg Anesthesiol. 2006;18(4):230-4.
- Abstract Viewed: 48 times
- PDF Downloaded: 25 times