1Assistant Professor, Department of Anaesthesiology, JJMMC, Davangere, Karnataka
2Assistant Professor, Department of Anaesthesiology, PES Institute of Medical Sciences & Research, Kuppam, Andhra Pradesh
Online published on 1 October, 2015.
Endotracheal intubation is a routine part of delivering general anaesthesia and pot intubation sore throat is the most common complaint following intubation. Cough, hoarseness, restlessness and PONV are other problems that follow intubation. Injury to the tracheal mucosa due to high intra cuff pressure is thought to be the cause for these problems. Inflating the cuff of an endotracheal tube with alkalinized lignocaine instead of air may decrease the incidence and severity of post intubation sore throat and other post intubation problems by preventing the rise in intra cuff pressure and also anaesthetizing the tracheal mucosa.
The study population consisted of 200 ASA physical status I and II patients undergoing elective orthopedic, spine and general surgeries, who were randomly divided into two groups. In group I the endotracheal tube cuff was inflated with alkalinized lignocaine and in group II air was used to inflate the cuff. Following extubation, the patients were assessed for a 24 hour period for sore throat using VAS scores and for cough, hoarseness, restlessness and PONV using a binary(yes/no) scale.
The mean VAS score for sore throat in the alkalinized lignocaine group at 15 minutes was 22.15 + 3.64 mm and in the air group it was 39.15+ 5.17 mm. At 24 hours, the VAS score for sore throat in the alkalinized lignocaine group was 4.15 + 2.5 mm and in the air group it was 19.1 + 4.16 mm. The incidence of cough, hoarseness, dysphonia and restlessness in the alkalinized lignocaine group was 25%, 18%, 12% and 18% respectively and in the air group it was 70%, 64%, 32% and 41% respectively.
From the present study it can be concluded that inflating the cuff of an endotracheal tube with lignocaine 40 mg + NaHCO3 (Alkalinized Lignocaine) can significantly decrease post intubation sore throat and other post intubation problems like cough, hoarseness, dysphonia and restlessness. Hence it is a safe and easy practice to inflate the cuff of an endotracheal tube with alkalinized lignocaine instead of air.
Endotracheal intubation, endotracheal tube cuff, alkalinized lignocaine, air, sore throat
