Aim: To compare the efficacy of intracuff alkalinized lidocaine (ICAL) vs. Intravenous (IV) Lidocaine in attenuating the ETT induced Emergence Phenomena.
Background: The commonest method to secure airway in general anaesthesia is the use of Endo Tracheal Tube(ETT), However the emergence are often complicated by ETT induced airway and circulatory reflexes which can lead to potentially dangerous complications.
Methods: 60 patients who were candidate for elective intermediate duration operations and were in class 1 and 2 of ASA. Patients were randomly assigned to receive ICAL (2% lidocaine mixed 1:1 with 1.4% NAHCO3) or an intra venous (IV) Lidocaine 2% 1mg/kg.
Coughing was evaluated as. The patients were also observed for development of sore throat, hoarseness of voice, laryngeal spasm and pharyngeal pain along with the vital signs during this emergence phase.
Results: ICAL is more potent in preventing cough (p-value0.005), severity of coughing (p-value 0.047) and also in preventing sore throat (p-value 0.014).there was no incidence of other side effects. Despite both groups showing increase in sympathetic stimulation but still, ICAL is better in both MAP and HR (p-value 0.004 and 0.055 respectively).
Conclusions: Intracuff alkalinized lidocaine is significantly more effective than IV lidocaine in suppressing cough, severity of cough, sympathetic stimulation and sore throat in patient undergoing surgeries between one and two hours.
Key words: Intra cuff lidocaine; Intravenous Lidocaine; ETT; Emergence coughing.
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