title: In vitro evaluation of diffusion of lidocaine and alkalinized lidocaine through the polyurethane membrane of the endotracheal tube.
abstract: OBJECTIVE
  Endotracheal tube (ETT) and its inflated cuff are likely to induce specific reactivity at the emergence time. In ICU, the tolerance of the ETT cuff could be a part of patient agitation and increased of sedation.
  
  
  METHODS
  Using specific ICU ETT cuff (thin polyurethane cuff), we perform an in vitro evaluation of diffusion of lidocaine and alkalinized lidocaine (L-B) across the PU cuff for a long duration. We evaluate the safety of this procedure by a daily injection into the cuff.
  
  
  RESULTS
  With lidocaine alone, we observed a low rate of diffusion through the cuff (<8% over 24h), whereas the L-B solution had a high diffusion (>90% over 24h). The released profiles were similar from day 0 to day 8, and no cuff rupture was reported over the 8-day study.
  
  
  CONCLUSIONS
  The safety, controlled release, and lack of deleterious effects on cuff membrane were confirmed. In case of unexpected cuff rupture, an adequate determination of the mixture allows to obtain a safe solution with the achievement of a physiological pH (7.4) and the small dose of lidocaine (40 mg).
authors.affiliation: Department of anesthesiology and pain medicine, university of Washington school medicine, Harborview medical center, Box 359724, 325 Ninth Avenue, Seattle, WA 98104, États-Unis; Laboratoire de pharmacie galénique et biopharmacie, université de Rennes 1, 2, avenue Pr Léon-Bernard, 35043 Rennes, France. Electronic address: estebe@uw.edu.
authors.forename: J-P
authors.initials: JP
authors.lastname: Estebe
authors.affiliation: Department of anesthesiology and pain medicine, university of Washington school medicine, Harborview medical center, Box 359724, 325 Ninth Avenue, Seattle, WA 98104, États-Unis.
authors.forename: M
authors.initials: M
authors.lastname: Treggiari
authors.affiliation: Department of anesthesiology and pain medicine, university of Washington school medicine, Harborview medical center, Box 359724, 325 Ninth Avenue, Seattle, WA 98104, États-Unis.
authors.forename: P
authors.initials: P
authors.lastname: Richebe
authors.affiliation: Department of anesthesiology and pain medicine, university of Washington school medicine, Harborview medical center, Box 359724, 325 Ninth Avenue, Seattle, WA 98104, États-Unis.
authors.forename: A
authors.initials: A
authors.lastname: Joffe
authors.affiliation: Laboratoire de pharmacie galénique et biopharmacie, université de Rennes 1, 2, avenue Pr Léon-Bernard, 35043 Rennes, France.
authors.forename: F
authors.initials: F
authors.lastname: Chevanne
authors.affiliation: Laboratoire de pharmacie galénique et biopharmacie, université de Rennes 1, 2, avenue Pr Léon-Bernard, 35043 Rennes, France.
authors.forename: P
authors.initials: P
authors.lastname: Le Corre
mesh_terms: D000465:Algorithms; D000779:Anesthetics, Local / Q000737:chemistry*; D001639:Bicarbonates / Q000737:chemistry; D004058:Diffusion; D006863:Hydrogen-Ion Concentration; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008012:Lidocaine / Q000737:chemistry*; D008567:Membranes, Artificial; D011140:Polyurethanes
chemical_list: D000779:Anesthetics, Local; D001639:Bicarbonates; D008567:Membranes, Artificial; D011140:Polyurethanes; D008012:Lidocaine
keywords: Alcalinisation; Alkalinized lidocaine; Ballonnet de sonde d’intubation; Bicarbonate; Cuff; Diffusion in vitro; Endotracheal tube; In vitro; Lidocaine; Lidocaïne; Polyurethane; Polyuréthane