Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 5;9(4):323-330.
doi: 10.14744/nci.2021.33407. eCollection 2022.

A randomized controlled trial to study the effect of intratracheal and intravenous lignocaine on airway and hemodynamic response during emergence and extubation following general anesthesia

Divya V Gladston  1 , Sudha Padmam  2 , Rajasree Omanakutty Amma  1 , Rachel Cherian Koshy  1 , K M Jagathnath Krishna  3 , Jayasree Vijayan  1 , Nimmy George  1 , Praveen Rajendran  1
Affiliations

A randomized controlled trial to study the effect of intratracheal and intravenous lignocaine on airway and hemodynamic response during emergence and extubation following general anesthesia

Divya V Gladston et al. North Clin Istanb. .

Abstract

Objective: Intratracheal (IT) and intravenous (IV) lignocaine suppress airway reflex and hemodynamic response during extubation, but studies regarding this are sparse. The primary aim was to compare the effect of IT and IV lignocaine on attenuation of airway reflex to endotracheal extubation and the secondary aim was to compare the hemodynamic responses to extubation, using lignocaine by the two different routes.

Methods: Seventy-five female patients with comparable age, body mass index, and American Society of Anesthesiologists Physical Status undergoing carcinoma breast surgery were randomized into three groups. Group A received 2% lignocaine 3 mg/kg intratracheally 5 min and Group B received 2% lignocaine 1.5 mg/kg intravenously 3 min before extubation. Group C was control group. The airway and hemodynamic responses were noted in terms of episodes of cough during emergence and extubation. Categorical variables assessed using Fisher's exact test and continuous variables assessed using one-way analysis of variance.

Results: Cough suppression was present in Groups A and B, with better results observed with IT than with IV lignocaine. In the control group, Grade III cough reflex was present predominantly. There was a statistically significant difference (p<0.001) in blood pressure and heart rate between Group A versus Group C and in Group B versus Group C, but not between Group A and Group B.

Conclusion: IT lignocaine administered before extubation significantly attenuates post-extubation cough reflex than IV lignocaine. Both IT and IV lignocaine can effectively attenuate the airway and hemodynamic response to extubation.

Keywords: Airway reflex; carcinoma breast; cough grade; extubation; hemodynamic stress response; intratracheal; intravenous; lignocaine; randomized controlled trial.

PubMed Disclaimer

Conflict of interest statement

No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
CONSORT diagram.
Figure 2
Figure 2
Graph comparing mean SBP among IT, IV, and control group. SBP: Systolic blood pressure; IV: Intravenous; IT: Intratracheal.
Figure 3
Figure 3
Graph comparing mean DBP among IT, IV, and control group. DBP: Diastolic blood pressure; IV: Intravenous; IT: Intratracheal.
Figure 4
Figure 4
Graph comparing mean HR among IT, IV, and control group. HR: Heart rate; IV: Intravenous; IT: Intratracheal.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Hess DR. The role of noninvasive ventilation in the ventilator discontinuation process. Respir Care. 2012;57:1619–25. - PubMed
    1. Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW. Management of the difficult airway: a closed claims analysis. Anesthesiology. 2005;103:33–9. - PubMed
    1. Tierney KJ, Murano T, Natal B. Lidocaine-induced cardiac arrest in the emergency department: effectiveness of lipid therapy. J Emerg Med. 2016;50:47–50. - PubMed
    1. Cooper RM. Extubation and Changing Endotracheal Tubes. Benumofs Airw Manag. 2007:1146–80.
    1. Shabnum T, Ali Z, Naqash IA, Mir AH, Azhar K, Zahoor SA, et al. Effects of lignocaine administered intravenously or intratracheally on airway and hemodynamic responses during emergence and extubation in patients undergoing elective craniotomies in supine position. Anesth Essays Res. 2017;11:216–22. - PMC - PubMed

LinkOut - more resources