Effect of endotracheal tube lidocaine instillation in prevention of smokers emergence coughing: sample of Iraqi patients undergoing emergency appendectomy

Jawad, Mohammed; Alsaady, Malath Azeez

doi:10.18203/2320-6012.ijrms20161981

Cited by 2 publications

(2 citation statements)

References 9 publications

(9 reference statements)

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“…We maintained the sedation level to achieve a Riker’s sedation agitation scale (SAS) score of 3 - 4 with baseline infusion of injected propofol at the rate of 0.2 - 1 mg/kg/h and maintained infusion of fentanyl at 25 - 100 µg/h to achieve a score of 0 - 1 on the 10-point non-verbal pain scale. [12 , 13] Level of sedation and haemodynamic parameters were monitored hourly. Propofol and fentanyl infusion was initially at the lowest dose.…”

Section: Methodsmentioning

confidence: 99%

A randomised controlled trial of intracuff lidocaine and alkalised lidocaine for sedation and analgesia requirements in mechanically ventilated patients

Saingur¹,

Naaz

Ozair

et al. 2022

SAJCC

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Background. Airway irritation caused by prolonged inflation of endotracheal tube (ETT) cuff results in post-intubation morbidities. Objective. We aimed to study intracuff lidocaine and alkalisedlidocaine on sedation or analgesia requirements of patients undergoing mechanical ventilation in the intensive care unit (ICU). The primary outcome was to calculate the total dose of propofol and fentanyl required to obtund the unwanted airway and circulatory reflexes. Secondary outcomes were to determine the frequency and severity of cough and haemodynamic parameters. Methods. It was a double-blinded, randomised controlled study in the ICU after emergency laparotomy, in patients aged 20 - 55 years, and classified as American Society of Anesthesiologists (ASA) classes 1E and 2E with tubein situ. Exclusion criteria were patients with body mass index >30 kg/m2, haemodynamic instability, requiring positive end-expiratory pressure ≥7 cm H2O, and a history of chronic obstructive pulmonary disease. After ethics clearance and written consent, patients were randomlyassigned into two groups (36 in each), Group L (ETT cuff inflated with lidocaine 2%)and Group AL (cuff inflated with a mixture of lidocaine 2% and sodiumbicarbonate 1:1). Results. Mean dose of propofol consumed in Group AL was significantly less than that in Group L (p<0.001). The mean standard deviation (SD) fentanyl utilisation in Group AL was 1 323.61 (187.27) μg, and that in Group L was 1433.09 (42.58) μg (p=0.040). Group L patients had a significantly higher incidence of cough than those in Group AL (p=0.01). There was no significant difference in the mean arterial pressure (p=0.22), although heart rate was significantly higher in Group L (p<0.001). Conclusions. Alkalised lidocaine reduces the requirement of sedation, analgesia, and the incidence of cough in intubated patients maintaining haemodynamic stability when compared with lidocaine.

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Section: Methodsmentioning

confidence: 99%

A randomised controlled trial of intracuff lidocaine and alkalised lidocaine for sedation and analgesia requirements in mechanically ventilated patients

Saingur¹,

Naaz

Ozair

et al. 2022

SAJCC

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“…It can also cause abrupt increase in intracavitary pressures (intraocular, intrathoracic, intra-abdominal, and intracranial) which could put patient at high risk. [ 4 5 ]…”

Section: Introductionmentioning

confidence: 99%

Attenuation of hemodynamic responses to endotracheal extubation with different doses of diltiazem with lignocaine: A placebo-controlled study

Swamy

Madhusudhana

2018

Anesth Essays Res

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Introduction:Endotracheal extubation causes transient hemodynamic stimulation leading to increase in blood pressure and heart rate (HR) due to increase in sympathoadrenergic activity caused by epipharyngeal and laryngopharyngeal stimulation. Lignocaine, a sodium channel blocker, attenuates the hemodynamic response to tracheal extubation by inhibiting sodium channels in the neuronal cell membrane, decreasing the sensitivity of the heart muscles to electric impulses. Diltiazem, a calcium channel blocker, attenuates hemodynamic response by blocking voltage-sensitive L type channels and inhibiting calcium entry-mediated action potential in smooth and cardiac muscle.Aims and Objectives:The aims and objectives of this are to study and to compare the efficacy of combination of intravenous (i.v.) diltiazem 0.1 mg/kg and i.v. lidocaine 1.0 mg/kg, diltiazem 0.2 mg/kg and lidocaine 1.0 mg/kg, lignocaine 1.0 mg/kg with normal saline given to attenuate exaggerated hemodynamic extubation responses and airway reflexes during extubation.Materials and Methods:This study was undertaken with 105 patients belonging to the age group 20–65 years with physical status ASA Classes I and II of either sex. Group A received injection diltiazem 0.1 mg/kg and preservative-free lignocaine 1 mg/kg. Group B received injection diltiazem 0.2 mg/kg and lignocaine 1 mg/kg. Group C received injection lignocaine 1 mg/kg with normal saline. In this study group, the drug dosage was fixed based on the previous studies.Results:At postextubation, significant difference in HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) were observed from 1 to 10 min between three groups. The difference in HR, SBP, DBP, and MAP were statistically significant between Group C in comparison with Group A and Group B from 1 min postextubation to 10 min.Conclusion:Combined diltiazem and lidocaine are more effective prophylaxis than lidocaine alone for attenuating the cardiovascular responses to tracheal extubation.

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Effect of endotracheal tube lidocaine instillation in prevention of smokers emergence coughing: sample of Iraqi patients undergoing emergency appendectomy

Cited by 2 publications

References 9 publications

A randomised controlled trial of intracuff lidocaine and alkalised lidocaine for sedation and analgesia requirements in mechanically ventilated patients

A randomised controlled trial of intracuff lidocaine and alkalised lidocaine for sedation and analgesia requirements in mechanically ventilated patients

Attenuation of hemodynamic responses to endotracheal extubation with different doses of diltiazem with lignocaine: A placebo-controlled study

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