Comparative evaluation of intra-cuff ropivacaine, bupivacaine, and lidocaine on emergence reactions after general anesthesia

Background: Emergence reactions are common after general anesthesia with tracheal intubation and can be associated with severe hemodynamic consequences. Inflating the cuff with local anesthetic instead of air has been reported to prevent these problems. However, no definitive results have been obtained for the effectiveness of this method. This study tried to come to a more reasonable conclusion by conducting more studies, and we used a variety of local anesthetics. Materials and Methods: This study was performed on 350 patients over 18 years undergoing general anesthesia using an endotracheal tube. Patients were divided into five groups based on endotracheal tube cuff inflation with lidocaine, ropivacaine, bupivacaine, isotonic saline, and air. After removing the endotracheal tube, patients were evaluated for cough, sore throat, and hoarseness. Results: Cough, sore throat, and hoarseness were observed in 43.7%, 27.4%, and 4.6% of cases, respectively. At all measured times, all reactions in all local anesthetic groups were weaker than in the air and saline groups. The difference between the local anesthetic groups was not significant. Conclusion: Using local anesthetics to inflate the endotracheal cuff reduces the incidence of emergence reactions from general anesthesia.