<p>Trans-Cricothyroid Membrane Injection of Local Anesthesia Attenuates Cough Response and Postoperative Sore Throat to the Nasotracheal Tube</p>

Abstract

Objective: This study aims to investigate the effects of trans-cricothyroid membrane injection of local anesthesia on cough response and postoperative sore throat to the nasotracheal tube. Methods: Patients who require general anesthesia with nasotracheal tube for oral and maxillofacial surgery were randomised divided into groups L and C. The patients in group L received trans-cricothyroid membrane injection of 2% lidocaine (3 mL) before anesthesia. Meanwhile, the same volume of 0.9% saline was administered to group C. The incidences of cough response, mean arterial pressure (MAP) and heart rate (HR) were recorded during emergency from general anesthesia. Postoperative sore throat (POST) was assessed at 1, 6, 12 and 24 h after surgery. Results: The data of 60 patients in group L and 61 in group C were included in this study. The incidence of cough was lower in group L than in group C, ie, 41.7% vs 67.2% upon extubation (P=0.006) and 20.0% vs 41.0% at five minutes after extubation (P=0.018). MAP and HR in group L were significantly lower than in group C during emergency from general anesthesia (P<0.05). POST incidence was significantly reduced in group L at 1 and 6 h after surgery, ie, 35.0% vs 55.7% at 1 h after surgery (P=0.029) and 20.0% vs 37.7% at 6 h after surgery (P=0.044). Conclusion: Trans-cricothyroid membrane injection of local anesthesia is a simple and effective method to attenuate the incidence of cough response during emergency from general anesthesia. This technique can reduce the incidence of POST after surgery.

Dexdemetomidine for Prevention of Cough Response and Agitation in Patients with Intubation after Flap Reconstructive Surgery for Oral Cancer

“…indicated that the incidence of agitation was nearly 65% after ap reconstruction [4,5]. These adverse events are related to activation of the sympathetic nervous system that manifests with serious cardiovascular responses, and severe agitation can lead to self-harm, failure of the transferred ap and greatly affect the patient's rehabilitation [3,4,16]. It's essential to take effective anesthetic to make the patient awake smoothly from general anesthesia and keep a well sedated state after ap surgery.…”

“…Moreover, at present, more and more patients kept tracheal catheter after ap surgery instead of tracheotomy with the rapid development of oral and maxillofacial ICU. However, the tracheal tube is a strong irritation and could increase postoperative cough response and agitation, which not only cause acute hemodynamic changes and failure of the transferred ap, but also signi cantly delay the patient's rehabilitation [3,4]. Allak et al indicated that agitation occurs in nearly 65% of patients after ap reconstruction [5].…”