Effects of application lidocaine intracuff and around the cuff on cardiovascular and respiratory responses to extubation

Effects of Application Lidocaine Intracuff and Around the Cuff on Cardiovascular and Respiratory Responses to Extubation In the present study; effectiveness of application lidocaine spray around the cuff before intubation and using lidocaine after intubation in the endotracheal tube cuff alone or together at side effects on cardiovascular and respiratory systems to extubation were investigated. Two hundred patients sheduled for gynecologic operation with ASA physical status of I or II, between 18-65 years old, in supine position and lasting over one hour at general anesthesia were enrolled. Patients randomly assigned to 4 equal groups; in Group I endotracheal tube cuff filled with air after intubation, in Group II 4 puff 10% lidocaine sprayed around the endotracheal tube cuff before intubation, in Group III endotracheal tube cuff filled with 2% lidocaine after intubation and in Group IV 4 puff 10% lidocaine sprayed around the endotracheal tube cuff before intubation and filled with 2% lidocaine. Same drugs were used in anesthetic induction and maintenance in all groups. After recording control datas systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, ETCO2, SpO2 and endotracheal tube cuff pressure parameters were measured and recorded in 5 minute intervals to the end of the operation. After extubation; the quality of extubation was examined, haemodynamic parameters were recorded in 5 minute intervals to discharging patient to the ward and Aldrette scores were examined. Postoperative sore throat, cough, hoarseness and also respiratory symptoms like dyspne, laryngospasm, broncospasm, stridor, gastrointestinal symptoms like nausea-vomiting examined and recorded when patients discharging to the ward and at postoperative 1. , 6. , 12. , 24. and 48. hours. Patients in all groups were interviewed in the ward and at house with telephone calls during at first 48 hours. Above these parameters patients? demographic features, ASA physical status and durations of anesthesia and surgeries were also recorded. Increases were examined at cardiovasvular system parameters after extubation in all groups and this increases continue for 5 or 15 minutes. The best criterias were examined in combination group for the quality of extubation and the other groups datas like each others. Postoperative sore throat in respiratory system findings were examined lowest in intracuff lidocaine and combination group, highest in control group. Postoperative cough was not noticed in combination group, the other groups were similar. Postoperative hoarseness was examined only at control and lidocaine spray around the cuff group. Significant decrease at SpO2 value on extubation and after extubation at first 5 minute in a patient at control group was noticed. At conclusion; application of 10% lidocaine spray around the endotracheal tube cuff before the intubation and 2% lidocaine in the cuff after intubation alone or together were found not decrease blood pressure and heart rate in cardiovascular system at early time period after extubation, were similar effects at decreasing and preventing respiratory system side effects. Key words: Lidocaine, spray, endotracheal tube, extubation, haemodynamic effect, pulmonary effect