Abstract

Smooth emergence from anaesthesia is necessary for preventing potential respiratory and hemodynamic instability. Coughing on the endotracheal tube during emergence can lead to tachycardia, hypertension, laryngospasm and hypoxemia. The objective of the study was to compare alkalinized 2% lignocaine with 0.9% saline for inflating endotracheal tube (ETT) cuff to reduce post-operative complications like cough, sore throat, hoarseness of voice, nausea and vomiting. Materials And Methods: This was a prospective randomized double blinded study conducted in tertiary care setup over a period of 3 months. We included 60 patients in age group of 18 to 60 years posted for elective surgeries lasting less than 120 minutes under general anaesthesia. Patients were randomized using computer generated randomization table into either group – Group A (Alkalinized 2% Lignocaine) or Group B (0.9% saline) with 30 patients in each group. Before induction, the anaesthesia provider was given a 20 ml syringe with either 0.9% saline or alkalinized 2% lignocaine. Anaesthesia provider was blinded to drug administration at the time of intubation. The ETT cuff was inflated with 0.9% saline or alkalinized 2% lignocaine in sufficient volume to establish a cuff pressure to prevent air from leaking during positive pressure ventilation. After extubation, the presence or absence of outcomes such as cough, sore throat, and hoarseness of voice was observed at 1, 6 and 12 hours post operatively. Results: Demographic data, baseline characteristics and duration of anaesthesia were comparable among study groups. Incidence of sore throat at one hour, 6 hour, 12 hours postoperatively was significantly reduced in Group A compared to Group B. Throat pain, coughing, hoarseness of voice were common in Group B. Discussion: In this study, the primary outcomes postoperative cough and sore throat showed a statistically significant decrease in 2% alkalinized lignocaine group when compared to Group B. Postoperative hoarseness of voice also showed statistically significant relation in Group A with no incidence at first hour of postoperative period. Conclusion: This study showed the significance of use of intracuff alkalinized 2% lignocaine in reducing the incidence of cough, sore throat during the postoperative period. This could be attributed to endotracheal tube acting like a semipermeable membrane through which alkalinized lignocaine diffuses out and exert its local effect on tracheal mucosa

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