The effect of endotracheal 1% lidocaine administration to reduce emergence phenomenon after general anesthesia

다국어 초록 (Multilingual Abstract)

Background: Endotracheal intubation often causes sore throat and coughing. The aim of this study was to decrease the incidence and severity of cough, sore throat, and hemodynamic changes after extubation by endotracheal administration of 1% lidocaine.
Methods: Sixty patients physical status American Society of Anesthesiologists classes I, II, and III who received a surgery under general anesthesia were randomly divided into two groups. L group was given 1% lidocaine 0.5 mg/kg by endotracheal administration.
The other group, N group, received the same volume of normal saline. The number of cough, the severity of sore throat with numerical rating score (NRS), incidence of local anesthetic systemic toxic reaction, laryngospasm, and hoarseness were recorded. In addition, the number of coughs was divided into three levels by its severity, and it was converted into an indicator of cough score.
Results: L group had a significantly lower number of cough and sore throat NRS (P value < 0.05) than the N group, and also hoarseness did not occur. The changes in the hemodynamic parameters, before and after the emergence of anesthesia, were more stable in the L group than those in the N group, but not statistically significant.
Conclusions: The results of this study suggest that endotracheal administration of 1% lidocaine is effective and safe method to reduce cough and sore throat caused by extubation.

참고문헌 (Reference)

1 Takita K, "Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation" 48 : 732-736, 2001

2 Soares SM, "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" 72 : 496-503, 2017

3 Oh YJ, "The effect of 10 % lidocaine spray on hemodynamics and postoperative sore throat accompanied by endotracheal intubation" 30 : 663-667, 1996

4 김난숙, "The Effect of Lidocaine Spray Before Endotracheal Intubation on the Incidence of Cough and Hemodynamics during Emergence in Children." 대한마취통증의학회 53 (53): 1-6, 2007

5 Asai T, "Respiratory complications associated with tracheal intubation and extubation" 80 : 767-775, 1998

6 Engelhardt T, "Pulmonary aspiration of gastric contents in anaesthesia" 83 : 453-460, 1999

7 Herlevsen P, "Prophylactic laryngo-tracheal aerosolized lidocaine against postoperative sore throat" 36 : 505-507, 1992

8 Leech P, "Proceedings : changes in intracranial pressure and systemic arterial pressure during the termination of anaesthesia" 46 : 315-316, 1974

9 McHardy FE, "Postoperative sore throat : cause, prevention and treatment" 54 : 444-453, 1999

10 Klemola UM, "Post-operative sore throat : effect of lignocaine jelly and spray with endotracheal intubation" 5 : 391-399, 1988

11 Pelton DA, "Plasma lidocaine concentrations following topical aerosol application to the trachea and bronchi" 17 : 250-255, 1970

12 Jee D, "Lidocaine sprayed down the endotracheal tube attenuates the airway-circulatory reflexes by local anesthesia during emergence and extubation" 96 : 293-297, 2003

13 Holden R, "Intra-ocular pressure changes using the laryngeal mask airway and tracheal tube" 46 : 922-924, 1991

14 Frank SG, "How acidic is the lidocaine we are injecting, and how much bicarbonate should we add?" 20 : 71-73, 2012

15 Bilotta F, "Endotracheal lidocaine in preventing endotracheal suctioninginduced changes in cerebral hemodynamics in patients with severe head trauma" 8 : 241-246, 2008

16 Bagchi D, "Efficacy of intravenous dexamethasone to reduce incidence of postoperative sore throat : a prospective randomized controlled trial" 28 : 477-480, 2012

17 Zhao G, "Continuous postoperative infusion of remifentanil inhibits the stress responses to tracheal extubation of patients under general anesthesia" 10 : 933-939, 2017