Abstract
Aim: To study and investigate the efficacy of intra-cuff alkalinized lidocaine in the prevention of the endotracheal tube (ETT) induced emergence phenomena in children.
Methodology: Fifty children, ages 6-12 years, ASA physical status I-II, scheduled for elective dental surgery under N2O free general anesthesia with an expected duration of 120 min or more, were randomly assigned one of the two groups (25 patients each); lidocaine group in which the cuff of ETT was inflated with a mixture of lidocaine 2% and sodium bicarbonate 8.4% and the saline group, in which tube cuff was inflated with 0.9% saline solution.
Results: There were significant reduction in the incidence and severity (p=0.005 & p=0.014) of cough at extubation and in the PACU (P=0.048 & P=0.014). The incidence and severity of postoperative sore throat was also reduced in the lidocaine group compared to the saline group (p=0.025 and 0.031 respectively). Moreover, there was a significant prolongation of the time to spontaneous ventilation before extubation in the lidocaine compared to the control group (16.4+/-3.1 min and 9.4+/-1.7 min respectively) with p value < 0.0001.
Conclusion: Intra-cuff alkalinized lidocaine reduces the incidence of cough, sore throat, improved ETT tolerance and inducing smooth extubation in paediatric patients, but prolongs time to spontaneous ventilation before extubation.