Indu S1, Arun M. G2, Taznim Mohamed3, Suvarna K4
CONTEXT
Emergence from general anaesthesia is associated with post extubation cough, hoarseness, sore throat, and dysphagia, which may affect the smoothness of extubation. Prophylactic interventions have been studied to reduce these tracheal morbidities with varying results.
AIMS
To compare the efficacy of air, alkalinised lignocaine and saline in maintaining intracuff pressure and reducing postoperative cough (PEC) and sore throat (POST).
SETTINGS AND DESIGN
A randomised controlled study conducted in a teaching hospital.
METHODS AND MATERIALS
105 patients scheduled for elective surgeries were randomly allocated into groups of 35 each. The endotracheal tube (ETT) cuffs were inflated with air, alkalinised lignocaine, or saline. The intracuff pressure (ICP) was initially set to 25-30 cm of H2O; measured every 30 minutes and before extubation; the minimum volume for occlusion (MOV) noted. The incidence PEC and POST were monitored.
STATISTICAL ANALYSIS
Data analysed using Chi-square test, Fisher’s exact test; Bonferroni method allowed multiple comparisons. A p value <0.05 was considered significant.
RESULTS
Pre-lubricated ETT cuff inflation with liquid media maintained an acceptable ICP. Saline and alkalinised lignocaine were effective in reducing PEC and POST. Alkalinised lignocaine provided smoother extubation and fared better in the early postoperative period.
CONCLUSIONS
Pre-lubricated ETT cuffs with liquid media reduced PEC and POST. Alkalinised lignocaine showed better profile than saline. Optimum ICP reduces tracheal morbidity.
