is an Assistant Professor of Anesthesiology and Medical Director of the Adult Extracorporeal Membrane Oxygenation Service, Mayo Clinic College of Medicine, Rochester, Minnesota. Email:
was a student in the Doctor of Nurse Anesthesia Practice Program at Mayo Clinic School of Health Sciences, Rochester, Minnesota at the time this article was written.
AANA J. 2023 Feb;91(1):7-13.
Tracheal mucosal inflammation and irritation caused by the endotracheal tube (ETT) may exacerbate symptoms of pain and discomfort which create challenges including ETT tolerance and postintubation emergence phenomena. Various sedative and analgesic agents are used to mitigate these symptoms, however, there is concern that such medications may contribute to prolonged duration of intubation, length of intensive care unit (ICU) stay, as well as increased morbidity. This randomized control pilot study explored the feasibility and potential efficacy of instillation of a buffered lidocaine solution as an ETT cuff medium in adult rapid recovery eligible cardiac surgical patients. Thirty-two patients were randomized to the intervention (1.8% lidocaine/0.76% sodium bicarbonate) or control (air) group. Data were analyzed using median, standard deviation (SD), Wilcoxon rank sum, mean ± SD, two-sample t-test, and Fisher's exact test. The intervention arm demonstrated a trend toward a reduction in the incidence of cough at ICU arrival (0 versus 22%), incidence of pharyngitis at all time intervals, and propofol requirement (345 ± 248 mg versus 1,158 ± 1,426 mg) with no difference in adverse events between groups. These results support the development of larger studies to confirm the efficacy and feasibility of buffered lidocaine as an ETT cuff medium in this population.
气管内管（ETT）引起的气管黏膜炎症和刺激可能会加重疼痛和不适的症状，这些症状会带来挑战，包括 ETT 耐受性和插管后出现的现象。各种镇静和镇痛药物被用于减轻这些症状，但人们担心这些药物可能会导致插管时间延长、重症监护病房（ICU）停留时间延长以及发病率增加。这项随机对照试验研究探索了在成人快速康复心脏手术患者中，使用缓冲利多卡因溶液作为 ETT 套囊介质的可行性和潜在疗效。32 名患者被随机分配到干预组（1.8%利多卡因/0.76%碳酸氢钠）或对照组（空气）。使用中位数、标准差（SD）、Wilcoxon 秩和检验、均值±SD、两样本 t 检验和 Fisher 确切检验进行数据分析。干预组在 ICU 到达时咳嗽的发生率（0 与 22%）、所有时间间隔的咽炎发生率和丙泊酚需求（345±248mg 与 1158±1426mg）呈降低趋势，但两组之间的不良事件无差异。这些结果支持开展更大规模的研究，以确认缓冲利多卡因作为该人群 ETT 套囊介质的疗效和可行性。
