THE EFFECT OF DIFFERENT ROUTES OF LIDOCAINE USAGE IN GENERAL ANESTHESIA ON POSTOPERATIVE COUGHAND SORETHROAT
Abstract
Background. Postoperative cough in general anesthesia is a common and also dangerous problem that can result in complications such as hypertension, tachycardia, cardiac arrhythmias, myocardial ischemia, bronchospasm, increased intracranial and intraocular pressure. This is important in operations such as cataract surgery in which increasing intraocular pressure can produce many complications. In this survey we used intravenous or topical lidocaine by different routs and evaluated the prevalence of postoperative cough and sorethroat.
Methods. In a clinical trial study, 204 ASA 1 and 2 patients prepared for cataract surgery under general anesthesia, were selected by convenience sampling and then randomized into six groups according to lidocaine usage route. All patients received intravenous fluid and were induced general anesthesia in a similar manner. Before intubation, in the first group lidocaine spray was used on the terminal end of tracheal tube; lidocaine spray was used on laryngopharyngeal stractures in 2nd group; terminal end of tracheal tube was lubricated with lidocaine gel; intravenous lidocaine at the end of operation was used in 4th group; intracuff lidocaine was used in 5th group and normal saline was used on the terminal end of tracheal tube in 6th group. At the end of surgery and after extubation, patients were evaluated about postoperative cough in the PACU. One hour and the day after surgery patients were cvaluated about sorethroat. The results are written as Mean±SD and Chi-square, ANOV A and multiple comparison tests used. P<0.05 is considered significant.
Findings. Mean age of patients was 63.7±11.9 of whom 51.8 percent were male and 42.2 percent weer fcmale. There was no significant difference between six groups condidering age, sex, smoking, duration of surgery, preoperative systolic and diastolic pressure and heart rate. In the PACU, 64.7 percent of patients suffered from cough that its incidence was more in 3rd, 6th and groups consequently and less in 4th and 5th groups documented by statistical analysis. The incidence of postoperative sorethroat was 52.5 percent after one hour and 17.2 percent one day later, which was greater in 3rd, 2nd and 6th groups consequently.
Conclusion. Reducing postoperative cough results in less complications and according to this study, using intracuff lidocaine or intravenous lidocaine at the end of operation will result in better outcome for patients and also better results for anesthesiologist and surgon.
Methods. In a clinical trial study, 204 ASA 1 and 2 patients prepared for cataract surgery under general anesthesia, were selected by convenience sampling and then randomized into six groups according to lidocaine usage route. All patients received intravenous fluid and were induced general anesthesia in a similar manner. Before intubation, in the first group lidocaine spray was used on the terminal end of tracheal tube; lidocaine spray was used on laryngopharyngeal stractures in 2nd group; terminal end of tracheal tube was lubricated with lidocaine gel; intravenous lidocaine at the end of operation was used in 4th group; intracuff lidocaine was used in 5th group and normal saline was used on the terminal end of tracheal tube in 6th group. At the end of surgery and after extubation, patients were evaluated about postoperative cough in the PACU. One hour and the day after surgery patients were cvaluated about sorethroat. The results are written as Mean±SD and Chi-square, ANOV A and multiple comparison tests used. P<0.05 is considered significant.
Findings. Mean age of patients was 63.7±11.9 of whom 51.8 percent were male and 42.2 percent weer fcmale. There was no significant difference between six groups condidering age, sex, smoking, duration of surgery, preoperative systolic and diastolic pressure and heart rate. In the PACU, 64.7 percent of patients suffered from cough that its incidence was more in 3rd, 6th and groups consequently and less in 4th and 5th groups documented by statistical analysis. The incidence of postoperative sorethroat was 52.5 percent after one hour and 17.2 percent one day later, which was greater in 3rd, 2nd and 6th groups consequently.
Conclusion. Reducing postoperative cough results in less complications and according to this study, using intracuff lidocaine or intravenous lidocaine at the end of operation will result in better outcome for patients and also better results for anesthesiologist and surgon.
Keywords
General Anesthesia, Intrateracheal Intubation, Cough, Sore Throat, Lidocaine