Clinical effects of lidocaine, serum physiologic or air filled into tracheal tube cuff

Abstract

In our study, the effects of lidocaine 10%, serum physiologic (saline) and air filled into endotracheal tube (ETT) cuff on intraoperative cuff pressures and hemodynamic parameters, postoperative bucking, laryngo-bronchospasm, cough and sore throat were investigated. Seventyfive ASA I-II patients aged between 18-70 undergoing operation in supine position were divided into 3 groups. Anaesthesia was induced with propofol 2-3 mg kg-1 and vecuronium 0.1 mg kg-1. The patients were intubated with standard high volume, low pressure ETT for women with inside diameter (ID): 7.5 mm and men with (ID) 9 mm. The ETT cuffs were filled with lidocaine 10% in Group L, serum physiologic 0.9% in Group S and with air in Group H. The cuffs were inflated so that no air leakage around the tube during mechanical ventilation at 20 cm H2O. ETT cuff pressures were measured each 10 minutes. There were no significant differences between groups in terms of demographic data, intraoperative and postoperative heart rates and mean arterial pressures. Postoperative 1st min oxygen saturation (SpO2) was lower in Group H than Group L and S (p<0.05). Intraoperative cuff pressures in Group H were higher than those of Group L and S beginning from 10th minutes of the operation (p<0.05). Peak cuff pressures and bucking were higher in Group H than Group L and S (p<0.05). Cough was not observed in Group L in the postoperative 0-2 min period (p<0.05). At postoperative 8 and 24 h, the incidence of sore throat was lower in Group L than Group S and H (p<0.05). In conclusion, we considered that filling the cuff of the ETT with liquid (saline or lidocaine) instead of air prevents the increase in cuff pressures due to nitrous oxide diffusion during general anaesthesia and filling the cuff with 10% lidocainc decreases the bucking, postoperative cough and sore throat incidences.