Postoperative Cough, Postoperative Sore Throat
Conditions
Keywords
Lidocaine 1%, Lidocaine 2%, Endotracheal tube cuff, Cuff inflation, Postoperative sore throat, Postoperative cough, General anesthesia, Endotracheal intubation
Brief summary
Comparing the effect of different methods of endotracheal tube cuff inflation on the occurrence of a postoperative sore throat and cough (Air vs Lidocaine 1% vs Lidocaine 2%).
Detailed description
Eligible patients undergoing general anesthesia will be randomized and assigned to three groups: Group A: Endotracheal tube cuff inflation with air Group B: Endotracheal tube cuff inflation with Lidocaine 1% Group C: Endotracheal tube cuff inflation with Lidocaine 2% The induction of anesthesia will be made following a preoxygenation with a facial mask with 100% Oxygen. It consists on the intravenous injection of Sufentanil 5 mcg or Fentanyl 50mcg, Lidocaine 1mg/Kg, Propofol 2.5mg/kg, Rocuronium 0.6mg/kg or Cisatracurium 0.15mg/kg. Maintenance of anesthesia will be done by sevoflurane + nitrous oxide, and reinjections of morphinomimetics and curare will be made as needed (the total doses will be noted at the end of the intervention). The intubation is made by a N° 7.5 tube in men and a N° 7 tube in women. Cuff inflation will be done upon placement of the endotracheal tube. The cuff's pressure will be monitored at several intervals of the intervention and kept \< or = 20 centimeter of water (cmH2O). The volume of lidocaine used will never exceed 5 mg / kg for the patient to be protected from the local toxicity of the local anesthetic in case of accidental rupture of the balloon. All patients will receive Paracetamol every 6 hours for the first 24 hours after the end of surgery.
Interventions
OTHERcuff inflation with air
Endotracheal tube cuff inflation with air
DRUGcuff inflation with lidocaine 1%
Endotracheal tube cuff inflation with lidocaine 1%
DRUGcuff inflation with lidocaine 2%
Endotracheal tube cuff inflation with lidocaine 2%
OTHERInduction of anesthesia
The induction of anesthesia will be made following a preoxygenation with a facial mask with 100% Oxygen. It consists on the intravenous injection of Sufentanil 5 mcg or Fentanyl 50mcg, Lidocaine 1mg/Kg, Propofol 2.5mg/kg, Rocuronium 0.6mg/kg or Cisatracurium 0.15mg/kg.
Maintenance of anesthesia will be done by sevoflurane + nitrous oxide, and reinjections of morphinomimetics and curare will be made as needed (the total doses will be noted at the end of the intervention).
OTHEREndotracheal intubation
The intubation is made by a N° 7.5 tube in men and a N° 7 tube in women. Cuff inflation will be done upon placement of the endotracheal tube. The cuff's pressure will be monitored at several intervals of the intervention and kept \< or = 20 centimeter of water (cmH2O).
OTHERSystematic post-operative analgesia
All patients will receive Paracetamol every 6 hours for the first 24 hours after the end of surgery.
Sponsors
Ogarite Habib
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients over 18 years old * American Society of Anesthesiologists classification (ASA) category 1 or 2 * High pressure, low volume endotracheal tube - (Lo-pro)
Exclusion criteria
* Ear nose and throat and cranial surgery * Ear nose and throat pathologies * Asthma and bronchial hyperreactivity * Chronic cough * Diabetes * Cognitive disorders * Swallowing disorders * Corticotherapy during the last week * Allergy to lidocaine * Urgent surgery * Nasogastric, oro-gastric * Ventral position * More than 2 intubation attempts * Continuous intravenous infusion of lidocaine intraoperatively.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sore throat intensity 0 | hour 0 after extubation | Throat pain evaluation using the visual analog scale of pain (range from 0 cm (no pain) to 10 cm (very intense pain)) |
| Sore throat intensity 2 | at 2 hours after extubation | Throat pain evaluation using the visual analog scale of pain (range from 0 cm (no pain) to 10 cm (very intense pain)) |
| Sore throat intensity 6 | at 6 hours after extubation | Throat pain evaluation using the visual analog scale of pain (range from 0 cm (no pain) to 10 cm (very intense pain)) |
| Sore throat intensity 24 | at 24 hours after extubation | Throat pain evaluation using the visual analog scale of pain (range: from 0 cm (no pain) to 10 cm (very intense pain)) |
| Cough intensity 0 | hour 0 after extubation | Cough intensity evaluation using the visual analog scale of cough (range from 0 cm (no cough) to 10 cm (very severe cough)) |
| Cough intensity 2 | at 2 hours after extubation | Cough intensity evaluation using the visual analog scale of cough (range from 0 cm (no cough) to 10 cm (very severe cough)) |
| Cough intensity 6 | at 6 hours after extubation | Cough intensity evaluation using the visual analog scale of cough (range from 0 cm (no cough) to 10 cm (very severe cough)) |
| Cough intensity 24 | at 24 hours after extubation | Cough intensity evaluation using the visual analog scale of cough (range from 0 cm (no cough) to 10 cm (very severe cough)) |
Contacts
Primary ContactOgarite P Habib, MD
Outcome results
None listed