Navarro Lais Helena Camacho, Braz José Reinaldo Cerqueira, Nakamura Giane, Lima Rodrigo Moreira E, Silva Fredson de Paula E, Módolo Norma Sueli Pinheiro
Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
Sao Paulo Med J. 2007 Nov 1;125(6):322-8. doi: 10.1590/s1516-31802007000600004.
High intracuff pressure in endotracheal tubes (ETs) may cause tracheal lesions. The aim of this study was to evaluate the effectiveness and safety of endotracheal tube cuffs filled with air or with alkalinized lidocaine.
This was a prospective clinical study at the Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista.
Among 50 patients, ET cuff pressures were recorded before, 30, 60, 90 and 120 minutes after starting and upon ending nitrous oxide anesthesia. The patients were randomly allocated to two groups: Air, with ET cuff inflated with air to attain a cuff pressure of 20 cmH2O; and Lido, with ET cuff filled with 2% lidocaine plus 8.4% sodium bicarbonate to attain the same pressure. ET discomfort before tracheal extubation, and sore throat, hoarseness and coughing incidence were studied at the time of discharge from the post-anesthesia care unit, and sore throat and hoarseness were studied 24 hours after anesthesia.
Pressures in Lido cuffs were significantly lower than in Air cuffs (p < 0.05). Tracheal complaints were similar for the two groups, except for lower ET discomfort and sore throat incidence after 24 hours and lower systolic arterial pressure at the time of extubation in the Lido group (p < 0.05).
ET cuffs filled with alkalinized lidocaine prevented the occurrence of high cuff pressures during N2O anesthesia and reduced ET discomfort and postoperative sore throat incidence. Thus, alkalinized lidocaine-filled ET cuffs seem to be safer than conventional air-filled ET cuffs.
气管内导管（ET）的高套囊压力可能导致气管损伤。本研究的目的是评估充气或充入碱化利多卡因的气管内导管套囊的有效性和安全性。
这是一项在圣保罗州立大学博图卡图医学院麻醉科进行的前瞻性临床研究。
在50例患者中，记录氧化亚氮麻醉开始前、开始后30、60、90和120分钟以及结束时的ET套囊压力。患者被随机分为两组：空气组，ET套囊充入空气以达到20 cmH₂O的套囊压力；利多组，ET套囊充入2%利多卡因加8.4%碳酸氢钠以达到相同压力。在麻醉后护理单元出院时研究气管拔管前的ET不适以及咽痛、声音嘶哑和咳嗽的发生率，并在麻醉24小时后研究咽痛和声音嘶哑情况。
利多组套囊压力显著低于空气组（p < 0.05）。两组的气管相关主诉相似，但利多组在24小时后ET不适和咽痛发生率较低，且拔管时收缩动脉压较低（p < 0.05）。
充入碱化利多卡因的ET套囊可防止氧化亚氮麻醉期间出现高套囊压力，并降低ET不适和术后咽痛发生率。因此，充入碱化利多卡因的ET套囊似乎比传统的充气ET套囊更安全。
