IJIMS.2018.125

Type of Article: Original Research

Volume 5; Issue 7: 2018

Page No.: 693-699

DOI: 10.16965/ijims.2018.125

PREVENTION OF POST INTUBATION SORE THROAT BY USING AN ALKALINIZED LIGNOCAINE FILLED ETT CUFF

Ch Anil Kumar 1, D Sandeep Kumar 2.

1 Assistant professor in Anaesthesia, Viswabharathi medical college, Penchikalapadu, Kurnool, Andhra Pradesh, India.

2 Senior resident in Anaesthesia, Viswabharathi medical college, Penchikalapadu, Kurnool, Andhra Pradesh, India.

Corresponding author: Dr. D Sandeep Kumar, Address: Department of Anaesthesia, Viswabharathi medical college, Penchikalapadu, Kurnool, Andhra Pradesh, India. E-Mail: sandeep2452@gmail.com

Abstract:

Sore throat is a common postoperative complaint after endotracheal intubation during general anaesthesia. The benefits of using alkalinized lignocaine to fill the cuff of an endotracheal tube to prevent post intubation sore throat were sought. A randomized controlled study was performed on 66 patients of ASA I-II status divided into 3 groups of 22 each. In the A group ETT was filled with air, in group PL plain lignocaine was used to inflate the cuff and in group AL alkalinized lignocaine was used to fill the ETT cuff. The degree of sore throat and other side effects of intubation like coughing, restlessness, dysphonia and hoarseness were assessed over 24 hours post-extubation. In this present study, incidence of sore throat was less when intracuff alkalinized lignocaine was used rather than plain lignocaine or air. Throat pain, restlessness, dysphonia and hoarseness were most common in the air group in which air was the inflating medium. Compared to plain lignocaine group, the incidence of side effects was less in the alkalinized lignocaine group. Thus our study showed benefit of using an alkalinized lignocaine filled ETT cuff in preventing post intubation sore throat.

Key words: Postoperative, Alkalinized lignocaine, Sore throat, Coughing, Restlessness, Dysphonia and Hoarseness.

REFERENCES

  1. Lev R, Rosen P. Prophylactic lignocaine use pre-intubation: a review. J Emerg Med 1994; 4: 499-506.
  2. Bidwai AV, Bidwai VA, Rogers CR, Stanley TH. Blood pressure and pulse rate responses to endotracheal extubation with and without prior injection of lignocaine. Anesthesiology 1975; 51: 171-3.
  3. Combes X, Schauvliege F, Peyrouset O, Motamed C, Kirov K, Dhonneur G, etal. Intracuff pressure and tracheal morbidity: influence of filling with saline during nitrous oxide anesthesia. Anesthesiology2001;95(5):1120–4.
  4. Bartlett D Jr. Jeffrey P, SantsAmbrogio G, Wise JC. Location of stretch recetors in the tracheal and bronchi of the dog. J Physiology (Lond) 1976; 258: 409-20.
  5. Camporesi EM. MortolaJP.Sant’ Ambrogio F, Sant’sAmbrogio G. Topical anaesthesia of tracheal receptors. J ApplPhysiol 1979; 47: 1123-6.
  6. De Joy RH. The minimum blocking concentration in: De Jong RH (Ed) Local anaesthetics. Springfield, Illinois: Charles C Thomas. 1977:51-62
  7. Butterworth JF, Strichartz GR. Molecular mechanism of local anaesthetics: a review. Anesthesiology 1990; 72: 711-34.
  8. Estebe JP, Dollo G, Le Corre, Le Naoures A, Chervanne F, Le verge R,etal. Alkalinization of intracuff lignocaine improves endotracheal tube-induced emergence phenomena. AnesthAnalg. 2002; 94(1):227-30.
  9. Matias E, Steen SN. Diffusion of lignocaine across the cuff of endotracheal tubes. Anesthesia and Analgesia.March 1994. 78(2 suppl): Abstract S 270.
  10. Sconzo JM, Moscicki JC, DiFazio CA. In vitro diffusion of lignocaine across endotracheal tube cuffs. Reg Anesth 1999; 15:37-40.
  11. Combes X, Schauvlleje F, Peyrouset O, Motamed C, Kirov K, Dhonneur G et al. Intracuff pressure and tracheal morbidity, influence of filling with saline during nitrous oxide anaesthesia. Anesthesiology 2001; 95: 1120-4.
  12. Ahmad NL, Norsidah AM. Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: A comparison between air and distilled water cuff inflation. Anaesth Intensive Care 2001; 29: 510-4.
  13. Seegobin RD, Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow; endoscopic study of effects of large volume cuffs. Br Med J 1984; 288: 965-8.
  14. Navarro RM, Baughman VL. Lignocaine in the endotracheal tube cuff reduces postoperative sore throat. J ClinAnaesth 1997; 9: 394-7.
  15. Altintas F, Bozkurt P, Kaya G, Akkan G. Lignocaine 10% in the endotracheal tube cuff: Blood concentration, hemodynamic and clinical effects. Eur J Anaesthesiol 2000; 17: 436-42.
  16. Bennett MH, Isert PR, Cumming RG. Postoperative sorethroat and hoarseness following tracheal intubation using air or saline to inflate the cuff: A randomized control trial. AnaesthInten Care 2000; 28: 408-13.
  17. Matias E. Effect of NaHCO3 on the diffusion of lignocaine through the wall of endotracheal tube cuff. Br J Anaesth 1995; 74: A-238.
  18. Dollo G, Estebe JP, Le Corre P, Chevanne F, Ecoffy C, Le Verge R. Endotracheal tube cuff filled with lignocaine as a drug delivery system: In vitro and in vivo investigations. Eur J Pharm Sci 2001; 13: 319-23.
  19. Steinhaus JE, Gaskin I. A study of intravenous lignocaineas a suppressant of cough reflex. Anesthesiology 1963; 24:285-90.
  20. Gefke K, Andersen LW,  Friesel E.Lignocaine given intravenously as suppressant of cough and laryngospasm in connection with extubation. After tonsillectomy. ActaAnaesthesiolScand 1983; 27:111-2.
  21. Christenson V, Ladegaard-Pedersen HJ, Skovsted P. Intravenous lignocaine as a suppressant of persistent cough caused by bronchoscopy. ActaAnaesthesiolScandSuppl 1978; 67: 84-6.
  22. Yukioka H, Yoshimoto N, Nishimura K, Fujimori M .Intravenous lignocaine as a suppressant of coughing during tracheal intubation.AnesthAnalg 1985; 64: 1189-92.
  23. Nishino T, Hiraga K, Sugimori K. Effects of i.v lignocaine on airway reflexes elicited by irritation of the tracheal mucosa in humans anesthetized with enflurane. Br J Anaesth 1990; 64: 682-7.
  24. Lais HC Navarro, Jose reinaldo Cerqueira Braz, Giane Nakamura, Rodrigo Moreina e Lima, Fredson de Paula e Silva, Norma Suvli Pinheire Modolo. Effectiveness and safety of endotracheal tube cuffs filled with air versus filled with alkalinized lignocaine: a randomized clinical trial LaisSao Paulo Med J. 2007;125(6):322-8.

Download Full Text TOC