Journal of Krishna Institute of Medical Sciences University (Apr 2024)
Comparative study of intracuff air vs alkalinized lignocaine on cuff pressure and tube tolerance under anaesthesia maintained by nitrous oxide
Abstract
Background: An endotracheal tube is commonly used during General Anesthesia (GA) and is associated with hemo-dynamic changes during and after surgery alongside other throat-related difficulties. Aim and Objectives: To compare the effect of intracuff air and alkalinized lignocaine on cuff pressure under anesthesia maintained by nitrous oxide and to assess the tube tolerance while emergence from anesthesia. To evaluate intraoperative hemodynamic changes and incidence of Post Operative Sore Throat (POST) and hoarseness. Materials and Methods: The present study was a prospective randomized single blinded study conducted among adult patients undergoing GA at a tertiary healthcare located in Coimbatore. After selecting participants based on the inclusion and exclusion criteria, 80 participants were randomized into two groups of 40 subjects each, with Group A: Air inflation up to 20 cm of water and Group B: Alkalinized lignocaine inflation up to 20 cm of water. The selected variables were checked just before surgery, during extubation, and as per follow-up periods, and collected variables were then analyzed using SPSS version 22.0 software. Results: Both the groups were comparable in their demographic profile. The mean cuff pressures in Group A were higher than Group B at all points. The cuff pressures at end of surgery were 39.17 ± 1.752 vs 27.13 ± 1.017 cm of water and this was statistically significant (p = 0.001). The mean Systolic Blood Pressure, Diastolic Blood Pressure, and pulse rate at the time of extubation showed a significant difference with p < 0.05. Better tube tolerance at the time of extubation was observed in Group B with p < 0.05. The incidence of POST and hoarseness was found to be reduced in Group B and this was found to be statistically significant (p < 0.05). Conclusion: Intracuff injection of alkalinized lignocaine is superior to the standard practice of injecting air when using nitrous oxide for GA. It resulted in lower cuff pressures which translated to better tube tolerance, improved hemodynamics, smoother emergence, and reduced incidence of POST.
