Armaghane Danesh Bimonthly Journal (Oct 2006)
Comparison of Post Extubation Complications in 3 Different States of Filling Endotracheal Tube Cuff with Lidocaine 4% in Elective Surgery Patients
Abstract
ABSTRACT: Introduction & Objective: Endotracheal intubation during general anesthesia is necessary to control the ventilation of patients during surgery. Nevertheless, the endotracheal tube as an external object can stimulate the patient’s airway during the emergence from general anesthesia and create different reactions and complications. To prevent these reactions, a wide variety of interventions have been examined. In this study, post-extubation endotracheal tube complications are investigated in 3 different states of lidocaine 4% for filling endotracheal tube cuffs. Materials & Methods: In this quasi-experimental clinical trial study executed in one of Shiraz hospitals during 2005-2006, 200 candidates of elective surgery being in class1 and 2 ASA were randomly divided into 4 groups (N=50). The endotracheal tube cuffs of each group members were filled with (5-10ml) distilled water, lidocaine 4%, alkalized lidocaine 4% and warmed alkalized lidocaine 4%, respectively. The patients were observed for complications such as cough (for 6 hrs), sore throat, hoarseness (for 24 hrs) and laryngospasm (immediately) after extubation. The data were analyzed by chi square and logistic regression using SPSS. Results: The findings revealed that the frequency of cough, sore throat and hoarseness was more in the control (distilled water) group as compared to the 2 groups of the study (alkalized lidocaine 4% and warmed alkalized lidocaine 4%). Distilled water and lidocaine 4% groups differed significantly in only the frequency of sore throat. The odds ratio of cough, sore throat and hoarseness was just significant for the distilled water group in comparison to warmed alkalized lidocaine 4 %. Furthermore the odds ratio of the above-mentioned complications was significant for the distilled water and lidocaine 4% groups in comparison to the warmed alkalized lidocaine 4% group. Among all the considered variables, the duration of tube existence in trachea was significantly effective in the frequency of complications. Conclusion: Filling endotracheal tube cuffs with alkalized lidocaine 4% and warmed alkalized lidocaine 4% decreases the frequency of the post-extubation complications (cough, sore throat and hoarseness). The odds ratio for the observed complications is less in the warmed alkalized lidocaine 4% group as compared to other groups.
