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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
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| the study group (Group A) | Experimental | Patients received four puffs of 10% lidocaine sprayed at the cuff of ETT and four puffs at laryngeal inlet |
|
| Comparator group (Group B) | Active Comparator | Patients received 15 mg/kg of 2% lidocaine intravenous injection prior to extubation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 10% lidocaine sprayed | Drug | four puffs of 10% lidocaine sprayed at the cuff of ETT and four puffs at laryngeal inlet |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in incidence of coughing | Coughing event was recorded by blinded anesthesiologist | the incidence was recorded during extubation and immediatly extubation |
| Measure | Description | Time Frame |
|---|---|---|
| Severity of coughing | 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 | the severity was recorded during extubation and immediatly extubation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| PORNTHEP KASEMSIRI | Khon Kaen University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Khon Kaen University | Khon Kaen | 40002 | Thailand |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23370978 | Result | D'Aragon F, Beaudet N, Gagnon V, Martin R, Sansoucy Y. The effects of lidocaine spray and intracuff alkalinized lidocaine on the occurrence of cough at extubation: a double-blind randomized controlled trial. Can J Anaesth. 2013 Apr;60(4):370-6. doi: 10.1007/s12630-013-9896-8. Epub 2013 Feb 1. |
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The randomized controled trial was conducted. the investigator allocated patient into two arms. 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
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The study based on a sequentially numbered list were prepared in the same way. Participant and outcome assessor were blined to the computer generated lists
| 2% lidocaine intravenous | Drug | 15 mg/kg of 2% lidocaine intravenous injection prior to extubation |
|
|
| Incidence of postoperative sore throat | 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. | the incidence was recorded within 24 hr after extubation |
| Incidence of dysphonia | Incidence of dysphonia was recorded by two blinded anesthetist nurses . | the incidence was recorded within 24 hr after extubation |
| Incidence of dysphagia | Incidence of dysphagia was recorded by two blinded anesthetist nurses . | the incidence was recorded within 24 hr after extubation |
| ID | Term |
|---|---|
| D008012 | Lidocaine |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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