title: The effectiveness of 4% intracuff lidocaine in reducing coughing during emergence from general anesthesia in smokers undergoing procedures lasting less than 1.5 hours.
abstract: Coughing commonly occurs in patients emerging from general endotracheal anesthesia and is prominent in smokers due to underlying airway irritation. Clinical techniques used to mitigate emergence coughing include intravenous narcotics, intravenous or topical lidocaine, and deep extubation. Reduction of coughing by instilling lidocaine into the endotracheal tube cuff has been shown to be effective in long cases. Research has not confirmed efficacy of this technique in short cases. Does administration of intracuff lidocaine decrease coughing during emergence of smokers in short cases requiring general endotracheal anesthesia? This study was a randomized, double blind, posttest-only design that included 38 patients. Investigators recruited the subjects, obtained consent, and provided a syringe containing 5 mL of 4% lidocaine or 5 mL of saline to the anesthesia provider. At time of intubation, the provider injected the contents of the syringe into the endotracheal tube cuff. The control group received 5 mL of saline, and the experimental group received 5 mL of 4% lidocaine. On emergence, the anesthesia provider counted and recorded the number of coughs before awake extubation. This study did not show a correlation between use of intracuff lidocaine and a decrease in emergence coughing in procedures lasting less than 1.5 hours in patients who smoke.
authors.affiliation: University of Michigan-Flint/Hurley Medical Center Anesthesia Program, USA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Wetzel
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ancona
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Cooper
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Kortman
authors.forename: Gayle B
authors.initials: GB
authors.lastname: Loniewski
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Lebeck
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000494:pharmacology / Q000627:therapeutic use*; D015400:Clinical Nursing Research; D003371:Cough / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007322:Instillation, Drug; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000379:methods / Q000451:nursing; D008012:Lidocaine / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D009719:Nurse Anesthetists; D009730:Nursing Assessment; D011182:Postoperative Care / Q000379:methods / Q000451:nursing; D012018:Reflex / Q000187:drug effects; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine