Lidocaine Given Intravenously as a Suppressant of Cough and Laryngospasm in Connection with Extubation after Tonsillectomy

Abstract

The preventive effect of lidocaine against coughing in the recovery period after general anaesthesia was observed. The study was carried out as a double-blind sequential trial. At the same time the incidence of laryngospasm was registered. Lidocaine or placebo was given intravenously just before extubation. Nineteen patients for tonsillectomy, all of them over the age of 15, randomly received a 2% solution of lidocaine 2 mg/kg body weight or placebo (saline) 2 min prior to expected extubation. We found that lidocaine in this dose given prophylactically just before extubation was able to inhibit and prevent coughing in the recovery period after general anaesthesia. None of the patients included in this study got laryngospasm, and none of the patients developed serious side-effects.

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

“…Moreover, evidence shows that mucosa damage and cuff rupture might be associated with lidocaine gel or spray on the ETC [ 41 , 42 ]. Second, intracuff administration prevents the risk of prolonged sedation after intravenous lidocaine injection [ 18 , 43 ]. Third, inflating ETC with lidocaine could avoid the cuff overinflation due to rapid trans-cuff N 2 O diffusion during general anesthesia [ 38 , 44 , 45 ].…”

Effect of total intravenous anaesthesia and balanced anaesthesia on the frequency of coughing during emergence from the anaesthesia

“…agents such as lidocaine, 8 short-acting opioids, 9 10 or dexmedetomidine 11 involve undesired sideeffects and may delay emergence from general anaesthesia. 22 Techniques involving the topical application of lidocaine 12 bear the risk of blocking airway reflexes and may predispose to aspiration. 23 Besides, the endotracheal instillation of fluid may itself induce coughing and agitation.…”

Rapid and reliable smooth extubation – Comparison of fentanyl with dexmedetomidine: A randomized, double-blind clinical trial

“…Although these changes are transitory, it could be a major concern for an anesthesiologist. Many drugs are used to attenuate the intubation response such as intravenous lignocaine,[ 3 ] short-acting opioids such as fentanyl and remifentanil,[ 4 5 ] esmolol,[ 6 ] labetalol,[ 7 ] intratracheal local anesthetic instillation,[ 8 ] dexmedetomidine[ 9 ] which can be used during extubation also. Extensive research has been done to attenuate hemodynamic responses to intubation, but the same care and precautions are seldom carried out for extubation.…”