The Effects of Xylocaine Spray for Pain Control Caused by Endotracheal Tube in Critical Care

Abstract

s u m m a r yBackground: The purpose of this study was to evaluate the efficacy and safety of Xylocaine spray for the pain caused by endotracheal tube, and its impact on patients' satisfaction of intensive care. Methods: A quantitative evaluation of the effect before and after Xylocaine spray on endotracheal tube pain relief, and a qualitative interview study of the impact of this intervention on patients' satisfaction of intensive care in a prospective, clinical investigation. Those in the medical intensive care unit being endotracheal intubated and being able to clearly communicate with the caregivers were enrolled after providing their inform consent. We prescribed Xylocaine 10% pump spray as frequently as demanded. Results: Nineteen patients were eligible for this study. The numerical rating scale of the throat pain before local Xylocaine spray were 8.82 AE 0.79, 7.98 AE 0.92, 7.07 AE 0.76, 6.37 AE 0.83 and 5.47 AE 1.23, sequentially, compared with after therapy results, which were 3.84 AE 0.86, 3.57 AE 0.74, 3.06 AE 0.70, 2.61 AE 0.77 and 1.96 AE 0.88 (p < 0.01). The interval between Xylocaine demanded gradually increased with time after endotracheal tube intubation, and was also different between the daytime and the night-time on the first day of admission (p < 0.001). Most of the patients suffered from throat pain due to endotracheal intubation, and they agreed their satisfaction was affected by the factors, the level of throat pain being controlled (correlation: 0.89, p < 0.01), and the caregivers' attitude with regard to the pain control (correlation: 0.46, p < 0.05). Conclusion: Xylocaine spray is demanded is an effective therapy to manage the pain caused by endotracheal tube, which is also crucial to meet patient satisfaction in intensive care.

The effectiveness of clinical pathway‐directed care on hospitalisation‐related outcomes in patients with severe traumatic brain injury: A quasi‐experimental study

“…The findings of the current study concur with the results of the aforementioned study (Lee et al., ), revealing significantly fewer cases of procedural pain in the intervention group than the control group. This may be because the clinical pathway encouraged nursing and medical staff to deliver best practice care around minimising the occurrence of procedural pain.…”

“…Lidocaine is widely used to reduce procedural pain, such as endotracheal or nasogastric tube insertion. Evidence from a prospective study of nineteen patients in a medical ICU in Taipei, Taiwan (Lee et al., ), lends some support to this practice, concluding that lidocaine spray is effective in reducing pain caused by endotracheal tube insertion.…”

Comparative study between oral acetaminophen and lidocaine spray on endotracheal tube-related sore throat in adult intensive care

“…Despite several studies indicating that LIDO application effectively reduces ETT-related local pain [10,17,40], other studies have demonstrated that local LIDO application prior to tracheal intubation increased the intensity of POST [29? ]. Because local LIDO application reduces the incidence of persistent cough [10,41,42], LIDO can effectively block electrical impulses from peripheral nerves around the laryngopharynx and larynx.…”

“…Patient age, disease type, emergent intubation complications, [12][13][14] and prolonged intubation [15] potentially result in local tissue injury in the ETT placement area. Because POST is a potential indicator of ETT-related sore throat in patients with an emergent condition and studies on the presentation and pain management of ETTinduced sore throat remains limited [16,17], management of ETT-related sore throat in critically ill patients is necessary.…”

Factors for advancing emergency airway management practice

“…Physicians should also pay attention to artificial airwayinduced discomfort because intubated patients are unable to voice their needs [40][41][42]. The care of postoperative sore throat has been extensively studied [9,43]; however, the medical care of discomfort from prolonged endotracheal intubation in critical patients has not been extensively explored [44][45][46][47]. The final article in this special issue compared the therapeutic effects of two common pain relievers, oral acetaminophen and local lidocaine application, on endotracheal tube-related sore throat in critically ill patients [48].…”