title: Endotracheal tube cuff lidocaine is not superior to intravenous lidocaine in short pediatric surgeries.
abstract: BACKGROUND
  Instillation of lidocaine into the endotracheal tube cuff is a method with reported efficiency in promoting a smoother emergence from anesthesia with endotracheal intubation. However, whether or not this method is helpful in children and in surgeries with short duration has not been investigated previously.
  
  
  METHODS
  176 ASA I-II children undergoing adenotonsillectomy were enrolled in this prospective, double-blind, randomized clinical trial. Patients were randomly allocated to two groups. Patients in the ECL group (n=88) were injected 2% lidocaine into their endotracheal tube cuff and received saline (1.5mg/kg) intravenously. The IVL group (n=88) received 1.5mg/kg of 2% lidocaine intravenously and saline into the endotracheal tube cuff. In both groups, intra-cuff injections were initiated immediately after insertion of the endotracheal tube and terminated before the cuff pressure reached 20 cmH(2)O. The parameters measured were: coughing (graded by a scale of 3 at the time of extubation), systolic and diastolic blood pressures and heart rate (from the time of extubation up to 5 min after extubation at 1-min intervals), and laryngospasm (defined as the presence of hoarseness or absence of airflow).
  
  
  RESULTS
  The groups were not different in sex, age, weight, height, body mass index, anesthesia duration, and baseline hemodynamic parameters. The grade of coughing was significantly higher in the ECL group. The incidence of laryngospasm and hemodynamic trends did not differ between the groups.
  
  
  CONCLUSIONS
  Our results indicate that intra-cuff lidocaine may not be beneficial in children and in surgeries with a short duration.
authors.affiliation: Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Behzadi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Hajimohamadi
authors.forename: Afshar Etemadi
authors.initials: AE
authors.lastname: Alagha
authors.forename: Mehdi
authors.initials: M
authors.lastname: Abouzari
authors.forename: Armin
authors.initials: A
authors.lastname: Rashidi
mesh_terms: D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D007442:Intubation, Intratracheal; D007826:Laryngismus / Q000209:etiology; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine