Abstract
BackgroundEndotracheal intubation is known to pose significant physiological, pharmacokinetic, and dynamic changes and postoperative respiratory complications in patients under general anesthesia.MethodAn RCT trial was organized by the Third Affiliated Hospital at Sun Yat-sen University, China. Patients were eligible for inclusion in the trial if they were over 60 years old and had upper-abdominal surgery during the induction of anesthesia and had enrolled in endotracheal intubations. The primary end point included cardiovascular reactions during the induction of anesthesia and endotracheal intubations and cough events during the recovery period. In the test group, 2 g of lidocaine/prilocaine cream (and in the control group, 2 g of Vaseline) were laid over the surface of the tracheal tube cuff.ResultsThe systolic blood pressure (F value = 62.271, p < 0.001), diastolic blood pressure (F value = 150.875, p < 0.001), and heart rate (F value = 75.627, p < 0.001) of the test group were significantly lower than the control group. Cough events during the recovery period in the test group were better (spontaneous cough, χ2 value = 10.591, p < 0.001; induced cough, χ2 value =10.806, p < 0.001).ConclusionIn older patients, coughing and cardiovascular reactions under anesthesia and endotracheal intubations were reduced, as a result of using lidocaine/prilocaine cream on the surface of the tracheal tube cuff.Trial registrationInternational Clinical Trials Network NCT02017392, 2013-12-16.
Highlights
Endotracheal intubation is known to pose significant physiological, pharmacokinetic, and dynamic changes and postoperative respiratory complications in patients under general anesthesia
The systolic blood pressure (F value = 62.271, p < 0.001), diastolic blood pressure (F value = 150.875, p < 0.001), and heart rate (F value = 75.627, p < 0.001) of the test group were significantly lower than the control group
There were no significant differences in the baseline characteristics of the patients between the two groups (Table 1)
Summary
Endotracheal intubation is known to pose significant physiological, pharmacokinetic, and dynamic changes and postoperative respiratory complications in patients under general anesthesia. Endotracheal intubation has been shown to cause significant physiological, pharmacokinetic, and dynamic changes, along with postoperative respiratory complications in patients under general anesthesia [1]. Transient hemodynamic changes during these periods increase myocardial oxygen consumption, leading to myocardial ischemia. This can increase the risk of cardiovascular and cerebrovascular diseases, and of morbidity and mortality, in older patients under general anesthesia. Stellate ganglion block can restrain the stress response from inducing anesthesia and endotracheal intubations [2]. Stellate ganglion blocks are invasive and the alternative approaches are not always satisfactory
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