The purpose of the study is to determined whether the administration of alkalized 4% lidocaine (160 mg) in the endotracheal tube cuff is effective in diminishing the incidence of coughing at extubation in surgeries lasting more than 2 hours without the use of nitrous oxide as an anesthetic agent.

The diffusion of nitrous oxide inside the endotracheal cuff leads to increase pressure, pain and coughing. Studies have shown benefit of alkalized lidocaine and other mediums within the cuff with nitrous oxide. No study has yet evaluated the benefit of alkalized lidocaine in long surgeries without the use of nitrous oxide.

Inclusion Criteria:

- ASA 1,2 or 3 patients requiring general anesthesia for an elective urological or gynecological surgery predicted to last more than 2 hours

Exclusion Criteria:

• Patient refusal
• Lidocaine allergy
• Any allergies to drugs or anesthetics used during the study
• Under 18 years of age
• Pregnant
• Previous airway surgery
• Cormack 3 or 4 or anticipated difficult airway
• Upper respiratory tract infection in the last month
• Active respiratory disease
• Chronic cough or throat pain
• Gastro-esophageal reflux disease or at risk for aspiration