Does intra-cuff alkalinized lidocaine prevent tracheal tube induced emergence phenomena in children?

ABSTRACT

To study and investigate the efficacy of intra-cuff alkalinized lidocaine in the prevention of the endotracheal tube [ETT] induced emergence phenomena in children.Fifty children, ages 6-12 years, ASA physical status I-II, scheduled for elective dental surgery under N2O free general anesthesia with an expected duration of 120 min or more, were randomly assigned one of the two groups [25 patients each]; lidocaine group in which the cuff of ETT was inflated with a mixture of lidocaine 2% and sodium bicarbonate 8.4% and the saline group, in which tube cuff was inflated with 0.9% saline solution.There were significant reduction in the incidence and severity [p=0.005 and p= 0.014] of cough at extubation and in the PACU [P=0.048 and P=0.014]. The incidence and severity of postoperative sore throat was also reduced in the lidocaine group compared to the saline group [p=0.025 and 0.031 respectively]. Moreover, there was a significant prolongation of the time to spontaneous ventilation before extubation in the lidocaine compared to the control group [16.4 +/- 3.1 min and 9.4 +/- 1.7 min respectively] with p value < 0.0001. Intra-cuff alkalinized lidocaine reduces the incidence of cough, sore throat, improved ETT tolerance and inducing smooth extubation in paediatric patients, but prolongs time to spontaneous ventilation before extubation