Lidocaine in the endotracheal tube cuff reduces postoperative sore throat

Abstract

Study objectives: To test the hypothesis that continuous application of local anesthesia at the contact area between the endotracheal tube cuff and trachea would reduce both the incidence and severity of postoperative sore throat by blocking the tracheal pain receptors with local anesthetic delivered via endotracheal tube (ETT) cuff.

Design: Double-blind randomized study.

Setting: University affiliate hospital.

Patients: 106 ASA physical status I and II patients.

Interventions: Patients' ETT cuffs were inflated with either air or lidocaine. The cuffs of the lidocaine group were prefilled with lidocaine for 90 minutes prior to intubation to saturate the cuff membrane. One hour and 24 hours following extubation, patients were asked about the presence and severity of postoperative sore throat.

Measurements and main results: There was no difference between groups in demographics or anesthetic management. The incidence of sore throat was significantly different at the 24-hour evaluation (59% air vs. 32% lidocaine, p = 0.01). Severity of sore throat was significantly worse with air at both evaluation periods (1 hour = 18.7 +/- 27.0 air vs. 7.90 +/- 18.1 lidocaine, p = 0.02; 24 hours = 25.6 +/- 27.5 air vs. 14.5 +/- 24.8 lidocaine, p = 0.03).

Conclusions: Using lidocaine to inflate the ETT cuff decreases the severity of postoperative sore throat at one hour, and both the incidence and severity at 24 hours.