Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan.
J Anesth. 2023 Oct;37(5):726-733. doi: 10.1007/s00540-023-03224-1. Epub 2023 Jul 14.
The use of an endotracheal tube (ET) cuff filled with alkalized lidocaine (AL) can suppress ET-induced emergence phenomena, such as hypertension, tachycardia and coughing, and postoperative sore throat (POST) and hoarseness (PH). The efficacy of intracuff lidocaine may vary depending on the cuff shape, but there has been no study on the effects of a tapered cuff filled with AL. We examined whether intracuff AL suppresses ET-induced emergence phenomena, POST and PH.
Sixty-two patients were enrolled in this study and the patients were randomly allocated to a group in which the tapered cuff was filled with AL (Group AL) and a group in which the tapered cuff was filled with normal saline (Group S). The primary outcomes of this study were changes in mean blood pressure (MBP) and heart rate (HR) at extubation. MBP, HR and the number of coughs were recorded before and up to 10 min after extubation. The degree of POST and the incidences of POST and PH were recorded at 15 min, 2 h and 24 h after extubation.
Changes in MBP before extubation and HR before and after extubation were significantly lower in Group AL than in Group S (p < 0.025). The number of coughs at extubation and the incidence of PH at 2 h after extubation were significantly lower in Group AL than in Group S (p < 0.0001 and p = 0.014, respectively).
AL in a tapered cuff significantly suppresses ET-induced cardiovascular changes in MBP and HR.
使用充满碱性利多卡因（AL）的气管内导管（ET）套囊可以抑制 ET 引起的苏醒现象，如高血压、心动过速和咳嗽，以及术后咽痛（POST）和声音嘶哑（PH）。套管内利多卡因的疗效可能因套管形状而异，但尚未研究充满 AL 的锥形套管的效果。我们检查了套管内 AL 是否抑制 ET 引起的苏醒现象、POST 和 PH。
本研究纳入了 62 名患者，并将患者随机分配到充满 AL 的锥形套管组（AL 组）和充满生理盐水的锥形套管组（S 组）。本研究的主要结局是拔管时平均血压（MBP）和心率（HR）的变化。在拔管前和拔管后 10 分钟内记录 MBP、HR 和咳嗽次数。在拔管后 15 分钟、2 小时和 24 小时记录 POST 程度以及 POST 和 PH 的发生率。
AL 组拔管前 MBP 和拔管前后 HR 的变化明显低于 S 组（p<0.025）。AL 组拔管时咳嗽次数和拔管后 2 小时 PH 的发生率明显低于 S 组（p<0.0001 和 p=0.014）。
锥形套管内的 AL 可显著抑制 ET 引起的 MBP 和 HR 心血管变化。
