Lidocaine 10% in the endotracheal tube cuff: blood concentrations, haemodynamic and clinical effects

Abstract

The purpose of this study was to evaluate the effects (common haemodynamic variables, peak cuff pressures, the incidence of reaction (`bucking') during extubation and the incidence of sore throat after operation) of lidocaine 10% instilled into the endotracheal tube cuff in intubated patients. Plasma concentrations of lidocaine were assayed. Seventy ASA class I±II patients scheduled for plastic surgery were studied. Patients were randomly divided in two groups: the cuff of the endotracheal tube was in¯ated with either lidocaine 10% (group L) or with saline (group S) immediately after endotracheal intubation. In group L patients, the haemodynamic changes were less (P < 0.05), and the peak cuff pressure was lower (P < 0.01) than for group S. At extubation, more patients reacted (`bucked') in group S (70.5% vs. 19.4%, P < 0.01). The incidence and severity of sore throat were signi®cantly lower in group L 1 and 24-h after extubation. Plasma lidocaine concentrations did not reach toxic values. Lidocaine 10%, compared with saline, in the endotracheal tube cuff was associated with less disturbance of haemodynamic responses and less incidence of bucking during tracheal extubation. Lidocaine was also effective in reducing of incidence and severity of sore throat after operation.

Effect of prophylactic benzydamine hydrochloride on postoperative sore throat and hoarseness after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled trial

“…Whereas inflation of the ETT cuff with lidocaine has been reported to alleviate postoperative sore throat, 8 application of lidocaine to the oropharyngeal cavity or laryngotracheal area seems to be ineffective. 9,10 Ketamine gargle has been suggested to reduce postoperative sore throat, but the systemic effect of ketamine may be of consequence.…”

Effectiveness and safety of endotracheal tube cuffs filled with air versus filled with alkalinized lidocaine: a randomized clinical trial

“…After tracheal extubation, the hemodynamic alterations are minimized, thus reducing the incidence of coughing. [13][14][15][16][17] Increasing the alkalinity of the local anesthetic using sodium bicarbonate also dramatically increases its diffusion through the ET cuff. This allows the possibility of reducing the dosage of local anesthetic.…”

Can Calcium and Sodium Channel Blockers Attenuate Hemodynamic Responses to Endotracheal Intubation?

“…The results of various studies, in the last decade, on the effect of hemodynamic responses to tracheal induction have varied considerably. Many studies have reported beneficial effect (29)(30)(31)(32)(33), while others showed no effect (5, [34][35][36]. The difference in the results of various studies involving lidocaine, to some extent, can be explained by differences in study designs including variations in patient population, age, and dose and timing of drug administration in relation to intubation (37).…”