COMPARATIVE STUDY OF ENDOTRACHEAL TUBE CUFF INFLATION WITH AIR VERSUS ALKALINIZED LIDOCAINE ON HEMODYNAMIC RESPONSE DURING EXTUBATION
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Keywords
Endotracheal tube, cuff inflation, alkalinized lidocaine, hemodynamic response, extubation, general anesthesia.
Abstract
Background: Extubation is a critical phase during general anesthesia and is often accompanied by significant hemodynamic responses such as tachycardia, hypertension, and arrhythmias. Various strategies, including pharmacological and non-pharmacological approaches, have been employed to attenuate these responses. Endotracheal tube (ETT) cuff inflation with alkalinized lidocaine offers a promising alternative to conventional air inflation by providing local anesthetic effects that can reduce mucosal irritation and associated hemodynamic fluctuations.
Aim: To compare the effects of endotracheal tube cuff inflation with air versus alkalinized lidocaine on the hemodynamic response during extubation in adult patients undergoing elective surgeries under general anesthesia.
Methods: This prospective, observational study involved 100 adult patients aged 18–60 years undergoing elective surgeries. Patients were randomly allocated into two groups of 50 each: Group A (ETT cuffs inflated with air) and Group L (ETT cuffs inflated with alkalinized lidocaine). Hemodynamic parameters, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO2), were recorded at baseline, immediately post-extubation, and 5 minutes post-extubation. Statistical analysis was performed to evaluate the differences between the two groups.
Results: Group L demonstrated significantly attenuated hemodynamic responses compared to Group A. Mean HR, SBP, and DBP were notably lower in the alkalinized lidocaine group immediately post-extubation and 5 minutes later. No significant differences in oxygen saturation were observed between the groups.
Conclusion: Inflation of ETT cuffs with alkalinized lidocaine effectively reduces hemodynamic stress during extubation compared to air inflation. This technique provides a simple and effective intervention for improving peri-extubation hemodynamic stability.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Dr. Asif Hussain
Senior Resident, Department of Anaesthesiology and Critical Care, Government Medical College Anantnag, India.
Dr. Junaid Jeelani
Senior Resident, Department of Anaesthesiology and Critical Care, Government Medical College Anantnag, India.
Dr. Showkat Ahmad Wani
Senior Resident, Department of Anaesthesiology and Critical Care, Government Medical College Anantnag, India.