The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

Navarro, Laís Helena Camacho; Lima, Rodrigo Moreira e; Aguiar, Andressa Simões; Bráz, José Reinaldo Cerqueira; Carness, Jeffrey M.; Módolo, Norma Sueli Pinheiro

doi:10.1590/s0104-42302012000200023

Cited by 16 publications

(16 citation statements)

References 21 publications

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“…After reviewing the full text of the remaining 153 reports, we found that 19 eligible RCTs published between 1997 and 2014 met our inclusion criteria [ 10 – 12 , 22 – 24 , 28 – 40 ]. Among the selected studies, 18 were published in English, and one in Spanish [ 40 ]; 12 investigated the effect of intracuff lidocaine without alkalinization [ 10 , 22 , 23 , 28 – 33 , 38 – 40 ], whereas 9 focused on alkalinized lidocaine [ 10 – 12 , 24 , 33 – 37 ]; and 8 used an inflated ETT cuff with saline as the control [ 24 , 28 , 29 , 31 , 33 , 36 , 39 , 40 ]; 6 chose air instead [ 10 – 12 , 22 , 35 , 38 ]; and both media were investigated 5 trials [ 23 , 30 , 32 , 34 , 37 ]. In certain RCTs, the researchers have simultaneously compared the efficacy of intracuff lidocaine with other routes or interventions, such as a direct larynx spray under a laryngoscope [ 24 , 31 , 38 , 40 ], the application of an ETT lubricant [ 10 – 12 , 34 , 36 , 38 ], intravenous injection [ …”

Section: Resultsmentioning

confidence: 99%

“…In certain RCTs, the researchers have simultaneously compared the efficacy of intracuff lidocaine with other routes or interventions, such as a direct larynx spray under a laryngoscope [ 24 , 31 , 38 , 40 ], the application of an ETT lubricant [ 10 – 12 , 34 , 36 , 38 ], intravenous injection [ 38 , 40 ], and intracuff lidocaine under different temperatures [ 33 ] and concentrations [ 29 ]. The substantial inconsistencies between the anesthetic techniques employed included the implementation of premedication [ 11 , 12 , 28 , 30 , 32 , 34 – 36 ], N 2 O [ 10 , 11 , 22 , 23 , 29 , 30 , 32 – 39 ], total intravenous anesthetics [ 31 , 37 ], continuous opioid administration [ 12 , 31 , 32 , 35 , 36 , 40 ], and the use of the minimal leakage technique (MLT) for cuff inflation [ 10 – 12 , 22 – 24 , 28 – 30 , 32 , 34 – 38 ]. The samples of the selected trials numbered from 38 to 204 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Our assessment of the methodological quality of the 19 selected studies is listed in Table 2 . Seven studies had described the methods of allocation generation [ 12 , 22 – 24 , 31 , 38 , 40 ]; 3 studies had detailed the methods of allocation concealment [ 28 , 37 , 40 ]; and detailed information regarding the blinding of patients as well as assessors has been specified in 11 studies [ 10 , 12 , 24 , 28 , 31 , 33 , 36 – 40 ]. Sixteen studies had performed an intention-to-treat analysis [ 10 – 12 , 22 , 23 , 28 – 31 , 33 – 39 ].…”

Section: Resultsmentioning

confidence: 99%

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Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2015

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BackgroundPostoperative sore throat and other airway morbidities are common and troublesome after endotracheal tube intubation general anesthesia (ETGA). We propose lidocaine as endotracheal tube (ETT) cuff inflation media to reduce the postintubation-related emergence phenomenon.MethodsWe searched PubMed, EMBASE, and Cochrane databases systematically for randomized controlled trials (RCTs) that have investigated the outcome of intracuff lidocaine versus air or saline in patients receiving ETGA. Using a random-effects model, we conducted a meta-analysis to assess the relative risks (RRs) and mean difference (MD) of the incidence and intensity of relevant adverse outcomes.ResultsWe reviewed nineteen trials, which comprised 1566 patients. The incidence of early- and late-phase postoperative sore throat (POST), coughing, agitation, hoarseness, and dysphonia decreased significantly in lidocaine groups, with RRs of 0.46 (95% confidence interval [CI]: 0.31 to 0.68), 0.41 (95% CI: 0.25 to 0.66), 0.43 (95% CI: 0.31 to 0.62), 0.37 (95% CI: 0.25 to 0.55), 0.43 (95% CI: 0.29 to 0.63), and 0.19 (95% CI: 0.08 to 0.5), respectively, when compared with the control groups. The severity of POST also reduced significantly (mean difference [MD] -16.43 mm, 95% CI: -21.48 to -11.38) at 1 h and (MD -10.22 mm, 95% CI: -13.5 to -6.94) at 24 h. Both alkalinized and non-alkalinized lidocaine in the subgroup analyses showed significant benefits in emergence phenomena prevention compared with the control.ConclusionOur results indicate that both alkalinized and non-alkalinized intracuff lidocaine may prevent and alleviate POST and postintubation-related emergence phenomena.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2015

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“…The incidence of POST is influenced by many factors such as intubation procedure, endotracheal tube (ETT) cuff 's pressure, ETT mobilization during procedure, coughing and aspirations before extubation. 2,3,4 After mucosae irritation with the ETT, lidocaine, with its analgesic and anti-inflammatory effects seems to be the first choice for POST topic therapy. Therefore, therapies using lidocaine were applied in order to lower its incidence and severity.…”

Section: Discussionmentioning

confidence: 99%

Post intubation Pharyngolaryngeal Pain in Otorhinolaryngology Surgery: Efficiency of Intra cuff and Extra cuff Lidocaine

Reda¹,

Mohamed²,

Bensaid³

et al. 2018

Res Pract Anesthesiol Open J

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Copyright 2018 by Reda H. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited. IntroductionPost-operative sore throat (POST) represents a real discomfort for patients. In short duration surgeries, sore throat complain can replace the post-operative pain. Many studies intended to reduce its incidence using multiples medications. ObjectiveAssess the efficiency of extra cuff lidocaine jelly 2% associated with intra cuff liquid lidocaine 2% on the post extubation syndrome. Materials and methodProspective study lead during 3 months in Otorhinolaryngology operating rooms. Inclusion criteria: Every intubation (naso or orotracheal) performed during this period. Exclusion criteria: upper airways surgery, tonsillectomy and patient's refusal. Patients were randomized in 3 groups: First (G1): Control group (inflated cuff with air), Second (G2): liquid lidocaine 2% injected intra cuff, Third (G3): Lidocaine 2% jelly applied on the external surface of the cuff associated with liquid lidocaine intra cuff. Patients were assessed for post-operative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery. ResultsNinety-nine patients were randomized (G1 n=30, G2 n=34, G3 n=35). The association of liquid and jelly lidocaine reduced POST at H1, H6, and H24 after patient's discharge (p respectively at 0.0001; 0.002; 0.003 and 0.004). There was no significant difference in blunting coughing (p=0.053) and post-operative nausea and vomiting (p=0.198) ConclusionThe association of liquid and jelly lidocaine was efficient in reducing the POST. This result needs to be supported by a larger study including an important number of patients. Brief Research ReportBrief Research Report | Volume 3 | Number 1|

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“…This may be attributed to laryngeal epithelial inflammation, metaplasia, or dysplasia due to chronic irritation by substances in cigarette smoke thus impairing laryngeal integrity and exposure of subepithelial airway receptors to stimuli. [35]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of preoperative Strepsils lozenges on incidence of postextubation cough and sore throat in smokers undergoing anesthesia with endotracheal intubation

2014

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Post-operative sore throat (POST) is an undesirable side effect of endotracheal intubation. Pharmacological and non-pharmacological measures have been utilized for minimizing the morbidity caused by POST. We have tested use of Strepsils lozenges in providing efficacy for decreasing POST in smokers presenting for surgery under general anesthesia with endotracheal intubation.Materials and Methods:100 patients, 20-65 years, American Society of Anesthesiologists (ASA) physical status I and II, either sex, history of smoking, posted for elective surgical procedure of more than 1 hour, requiring general anesthesia with endotracheal intubation were included and randomly divided into groups (n = 50) to receive Strepsils (Group A) and sugar candy (Group B). The patients were assessed for cough, sore throat, and hoarseness of voice after extubation, 30 min, 12 hrs, and 24 hrs after extubation.Results:At extubation no cough was seen in 39 (78%) patients (group A) compared to 23 (46%) patients (Group B), and mild cough in 22% (Group A) and 52% (Group B). Incidence of sore throat at extubation was lower in group A compared to Group B (P = 0.04). At other times of observations (30 min,12 hrs and 24 hrs) there was a significant decrease in incidence of sore throat in Group A compared to Group B (P = 0.000). Hoarseness of voice was not observed in any patient in either group.Conclusions:Use of preoperative Strepsils lozenges decreases incidence of POST and maybe utilized as a simple and cost-effective measure for decreasing the symptoms of POST and increasing the satisfaction of patients.

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The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

Abstract: The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

Cited by 16 publications

References 21 publications

Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Post intubation Pharyngolaryngeal Pain in Otorhinolaryngology Surgery: Efficiency of Intra cuff and Extra cuff Lidocaine

Evaluation of preoperative Strepsils lozenges on incidence of postextubation cough and sore throat in smokers undergoing anesthesia with endotracheal intubation

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