Cough, Lidocaine
Conditions
Brief summary
Cough suppression during emergence and tracheal extubation from general anaesthesia has become an important issue as part of patient safety. Cough arised from the mechanical irritation of endotracheal tube and cuff could be accompanied by various adverse effects such as laryngospasm, hypertension, tachycardia, arrhythmia and increase of intracranial, intraocular, or intra-abdominal pressure. Several cough-preventing strategies have been proposed for smooth emergence, such as opioids, dexmedetomidine or lidocaine. Maintenance of remifentanil infusion during emergence has been reported to be an effective method in reducing cough and cardiovascular change without delay of recovery. In previous studies, the effetive effect-site concentraions for 95% of adults (EC95) for preventing cough are a little different depending on anaestheic agent, type of surgery and sex, ranged from 2.14 to 2.94 ng/ml. However, since most of these studies are for sing lumen endotracheal tube, similar preventing effect would not be expected for double lumen tube (DLT) because of its large diameter and long length. Another problem is higher concentration of remifentanil more than 2.5 ng/ml could not guarantee the safety after extubation. The efficacy of a single IV bolus of lidocaine for the prevention of cough has been the subject of numerous trials. Therefore, combined use of lidocaine and remifentanil could effectively prevent emergence cough for DLT without the risk of high concentration of remifentanil.
Interventions
DRUGLidocaine Iv
Bolus dose of 1.5 mg/kg lidocaine was injected immediate after operation.
DRUGRemifentanil
Continuous infusion of remifentanil 1.5 ng/ml until extubation
Sponsors
Ajou University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
MALE
Age
19 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients needs for double lumen tube intubation for one lung ventilation during surgery with ASA (American society of Anesthesiologists) class I or II
Exclusion criteria
* Gastroesophageal reflux disease * Obese patients (BMI \> 30) * Recent upper respiratory infection history (within 3 weeks) * Asthma history * Anticipating difficult airway
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cough incidence | from the time of end of the operation up to 10 min after extubation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cough severity | from the time of end of the operation up to 10 min after extubation | cough severity is graded as follows; mild cough (1 cough without lifting head), moderate cough ( more than 1 cough not sustained more than 5 seconds), severe cough (cough sustained more than 5 seconds) |
| hoarseness | 30 min at the recovery room | — |
Countries
South Korea
Contacts
Primary ContactJi young Yoo, assistant professor
Outcome results
None listed