Intra-Cuff lignocaine, saline, Air and hydrocortisone on incidence of post-extubation airway complications – A randomised controlled study

Abstract

Sore throat and coughing after tracheal extubation is a common clinical problem encountered during general anaesthesia. These complications ha ve been directly correlated with the size of the endotracheal tube used during surgery. There is no effective treatment at present for postoperative sore throat or hoarseness inspite of attempts to reduce its incidence and severity. Objectives: This research was designed to assess incidence of sore throat, coughing and hoarseness of voice following extubation with intracuff air, saline, 4% lignocaine and hydrocortisone. Materials and Methods: We included 400 patients in the age group 18-65 years belonging to ASA I and II undergoing elective general, orthopaedic, gynaecological, and urological surgeries under GA in the study. Based on the agent used for inflation of cuff randomization was done into four groups of 100 patients each namely group A (Cuff inflation with air), S (Cuff inflation with saline), L (Cuff inflation with lignocaine) and H (Cuff inflation with hydrocortisone). The study was single blinded by keeping the anaesthesiologist away who was not present at the time of intubation assessed cough, sore throat and hoarseness scores to achieve the blinding. Results: The incidence of sore throat in group L was significantly less compared to other groups at all the four intervals. Also, the overall incidence of cough was significantly less in group L at all the four intervals except at 24 hours where group L, H also had fewer patients reporting cough. With respect to hoarseness, group L was significantly better than group H and group S but the hoarseness was the worst in group A. Conclusion: The present study confirmed that, 4% lignocaine as cuff inflating agent, reduce d the incidence of postoperative sore throat, cough and hoarseness when compared to air, normal saline and hydrocortisone. Keywords: Intra-Cuff Lignocaine, Saline, Air, Hydrocortisone, Post-extubation airway complications.