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Alkalized lidocaine in a tapered cuff suppresses endotracheal tube-induced hemodynamic changes: a randomized controlled trial

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

AL in a tapered cuff significantly suppresses ET-induced cardiovascular changes in MBP and HR.

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Data availability

The datasets used and/or analyzed during the present study are available from the corresponding author upon reasonable request.

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Acknowledgements

We gratefully acknowledge Dr. Shigeru Ohmori (Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan) for excellent assistance in measuring the concentrations of lidocaine.

Funding

This study was supported by the Shinshu University School of Medicine.

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Authors and Affiliations

  1. Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan

    Kumiko Ishida, Yuki Maruyama, Yuki Yoshiyama, Mariko Ito, Satoshi Tanaka, Dandan Shen & Mikito Kawamata

Authors
  1. Kumiko Ishida
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  2. Yuki Maruyama
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  3. Yuki Yoshiyama
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  4. Mariko Ito
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  5. Satoshi Tanaka
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  7. Mikito Kawamata
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Contributions

KI designed the study and KI and MK wrote the original draft. KI, YY and MI performed the clinical experiments. YM performed the in vitro assays of the experiments. D.S. analyzed the data. ST edited the manuscript. MK supervised the study. KI conceived the original idea. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kumiko Ishida.

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Ishida, K., Maruyama, Y., Yoshiyama, Y. et al. Alkalized lidocaine in a tapered cuff suppresses endotracheal tube-induced hemodynamic changes: a randomized controlled trial. J Anesth 37, 726–733 (2023). https://doi.org/10.1007/s00540-023-03224-1

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  • DOI: https://doi.org/10.1007/s00540-023-03224-1

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