Comparison of intracuff dexamethasone, lignocaine and normal saline on post extubation response - A prospective study
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 5, Issue 3
Abstract
Background: Endotracheal intubation, being a definitive method has been known to cause post-intubation airway related adverse effects, including postoperative cough, restlessness, hoarseness, sore throat, bronchospasm, and laryngospasm. Cough induced by endotracheal tube can result in potential dangerous complications including hypertension, tachycardia, dysrrhythmia, increased intraocular pressure, increased intracranial pressure, wound dehiscence etc. Also intubation causes irritation and inflammation of airway. Sore throat and hoarseness incidence varies from 14.4 to 50%. Lignocaine administered intracuff has repeatedly been shown to reduce the incidence of post-intubation airway related adverse effects. Dexamethasone, a potent corticosteroid by its anti-inflammatory actions, reduce the incidence of postoperative cough, restlessness, hoarseness and sore throat. Aim and Objectives: The aim of this study is to evaluate and compare the effectiveness of intra-cuff dexamethasone and lignocaine with normal saline as a control group, in reducing postextubation airway related adverse effects like incidence of cough, sore throat, and hoarseness. Methodology: Study was conducted on 150 patients,divided in three groups, belonging to ASA physical status Grade I and Grade II. ETT cuffs in the first to third groups will be filled with normal saline, dexamethasone, and 2% lidocaine, respectively. The patient will be assessed for coughing on the ETT, restlessness before extubation and hoarseness in the recovery area before discharge. Hemodynamic indices, and incidence of post-extubation sore throat, cough and hoarseness at 1 hour, 6 hour, 12 hours was assessed. The Statistical oftware namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data Results: Lignocaine used to inflate the cuff of an endotracheal tube results in better tolerance of the endotracheal tube. Dexamethasone has lesser incidence of cough, sorethroat, hoarseness compared to lignocaine but not statistically significant. AMBU cuff pressure manometer is reliable for intracuff measurement.
Authors and Affiliations
Soumya M V, Sanjeev G M
Keywords
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