Abstract
BackgroundIntravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery.MethodsOne hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 μg/kg loading, 0.4 μg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The primary outcomes of cough were recorded. Secondary outcomes included hemodynamic variables, awareness time, volume of drainage, the postoperative visual analogue scale and adverse effects were recorded.ResultsThe incidence of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than that in the CON group (66.7%) (P = 0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than these in the CON group (43.4%) (P < 0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group during tracheal extubation (P < 0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 48 h after surgery (P < 0.05). compared with the CON group, the postoperative visual analogue scale was significantly lower in groups LIDO and DEX after surgery(P < 0.05). Compared with the LIDO group and the CON group, the time to awareness was longer in the DEX group (P < 0.05). In the DEX group, bradycardia was noted in 35 patients, while no bradycardia was noted in LIDO group and CON group.ConclusionCompared with intravenous infusions of normal saline, both lidocaine and dexmedetomidine had equal effectiveness in attenuating cough and hemodynamic changes during the tracheal extubation period after thyroid surgery, and both of these treatments were able to reduce the volume of postoperative bleeding and provide better analgesic effect after surgery. But intravenous infusions of dexmedetomidine resulted in bradycardia and delayed the time to awareness when compared with lidocaine and normal saline.Trial registrationChiCTR1800017482. (Prospective registered). Initial registration date was 01/08/2018.
Highlights
Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough
The incidences of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than in the CON group (66.7%) (P = 0.000)
Compared with the CON group, the volume of drainage was significantly reduced in the LIDO group and the DEX group within the first and second 24 h after surgery (P < 0.05), and there was no difference in the volume of drainage between the two treatment groups (Table 4)
Summary
Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. Two studies showed that the administration of single-dose 0.5 mg/kg dexmedetomidine before the end of surgery effectively reduced cough during anesthetic emergence [10, 11]. A previous report showed that an intravenous administration of lidocaine can inhibit cough during extubation [12]. Even though both of these treatments have been reported to effectively inhibit cough on the emergence from general anesthesia, but the differences between intravenous lidocaine and dexmedetomidine in inhibiting cough during the tracheal extubation period are unclear
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