Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

Abstract

Background: Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. Methods: One hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 µg/kg loading, 0.4 µg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The incidences and severities of cough were recorded within 2 minutes after the extubations. Hemodynamic variables were measured at T0 (before the induction of anesthesia), T1 (immediately after the extubation) and T2 (5 minutes after extubation). The volume of drainage was recorded within 24 hours after the surgeries. Results: The incidences of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than in the CON group (66.7%) (P=0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than in the CON group (43.4%) (P<0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group at T1 and T2 (P<0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 24 hours after surgery (P<0.05). Conclusion: Both intravenous infusions of lidocaine and dexmedetomidine had equal effectiveness in attenuating cough, hypertension, and tachycardia during the tracheal extubation period in patients undergoing thyroid surgery. Additionally, there was no significant difference in the reduction of postoperative drainage between the two treatments. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017482 (date of registration August 2018). Keywords: Lidocaine, Dexmedetomidine, Cough, Thyroid surgery.