Comparison Between nebulized Lidocaine and Budesonide for Prevention of airway complications after adult ophthalmic surgeries

Abstract

BACKGROUND:Securing the airway is the most important part of safe anesthesia. In clinical practice there is always a potential risk for encountering endotracheal intubation (ETT) related airway complications especially laryngospasm which can lead to acute desaturation and subsequent organ dysfunction. Nebulization of lidocaine can achieve highly effective anesthesia from oral cavity up to trachea for intubation without significant elevation in lidocaine blood level. Simplicity and lack of discomfort is the major advantage of this technique. Budesonide nebulizer suspension is nebulized corticosteroids used in treating chronic obstructive pulmonary disorders and to improve upper airway function.PATIENTS AND METHODS: 120 patients were encountered in the study and subjected to physical examination, vital signs (heart rate, blood pressure, and peripheral oxygen saturation), cardiac and pulmonary conditions were evaluated. All patients were investigated for complete blood count, Liver functions test, kidney functions test and coagulation profile. Patients were randomly assigned into one of three groups using computer generated randomization softwareRESULTS: Perioperative patient management and data collection will be done by an independent anesthesiologist who is blinded to patient's group CONCLUSIONS: Pre-induction nebulized lidocaine and budesonide can prevent post-extubation laryngospasm. Nebulized Budesonide (250 ucg) and to less extent nebulized lidocaine (60 mg) can reduce the incidence of post-extubation laryngospasm, cough, sore throat and hoarseness of voice.