The effect of different lidocaine application methods on postoperative cough and sore throat

Abstract

Study Objective: To evaluate the efficacy of various ways of lidocaine application in reducing postoperative cough and sore throat. Design: Double-blind, randomized study. Setting: University-affiliated hospital. Patients: 204 ASA physical status I and II patients scheduled for cataract surgery with general anesthesia. Interventions: Patients were randomized to six groups (G1, G2, G3, G4, G5, and G6), according to lidocaine application method. Before endotracheal intubation, in the G1 and G2 groups, 10% lidocaine was sprayed on the distal end of the endotracheal tubes (ETTs; G1) and laryngopharyngeal structures (G2). In the G3 group, the distal ends of the ETTs were lubricated with 2% lidocaine jelly. Intravenous (IV) lidocaine was administered to the G4 group at the conclusion of surgery. Intracuff lidocaine was used in the G5 group; in the G6 group, the terminal end of the ETTs were lubricated with normal saline. Measurements: At the end of surgery and after extubation, patients were observed to record the number of coughs. At 1 hour and at 24 hours following extubation, sore throat was evaluated. Main Results: In the recovery room, 64.4% of the patients experienced cough, with greatest frequency in the G3, G6, and G2 groups, and the least in the G5 and G4 groups. The frequency of sore throat was significantly different among the six groups at 1 hour and at 24 hours, with greater frequency in the G3, G2, and G6 groups. Conclusions: Using lidocaine to inflate the ETT cuff or IV lidocaine at the end of surgery decreases the frequency of postoperative cough and sore throat and would provide better outcome for patients and the physician.