Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena
We sought to determine the benefits of using alkalinized lidocaine 40 mg to fill the cuff of a tracheal tube (ETT) in combination with water-soluble gel lubrication to prevent post-intubation sore throat. The work included an in vitro study of the diffusion of alkalinized lidocaine solution through...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2004-03, Vol.92 (3), p.361-366 |
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| creator | Estebe, J.-P. Delahaye, S Le Corre, P Dollo, G Le Naoures, A Chevanne, F Ecoffey, C |
| description | We sought to determine the benefits of using alkalinized lidocaine 40 mg to fill the cuff of a tracheal tube (ETT) in combination with water-soluble gel lubrication to prevent post-intubation sore throat.
The work included an in vitro study of the diffusion of alkalinized lidocaine solution through the low-pressure, high-volume cuff of an ETT. We also performed a randomized controlled study (n=20 patients in each group) that included a group who received an alkalinized lidocaine-filled ETT cuff with lubrication of the tube using water-soluble gel (Group G), and two control groups who received an alkalinized lidocaine-filled cuff with ETT lubrication with water (Group W) or an air-filled cuff with ETT lubrication with water (Group C).
Water-soluble gel lubrication (Group G) produced a lower incidence of sore throat during the 24-h post-extubation period than lubrication with water alone in the cuffs filled with alkalinized lidocaine (Group W), and compared with the air control group. The ability of lidocaine to pass through the cuff of an ETT when water-soluble gel and/or water alone was used as a lubricant was similar, as determined by lidocaine plasma concentrations (Cmax 45 ng ml−1). Cough and restlessness before tracheal extubation were decreased in patients with the alkalinized lidocaine-filled cuffs compared with the air-filled cuffs. After extubation, nausea, vomiting, dysphonia and hoarseness were greater for patients with air-filled cuffs compared with the lidocaine-filled cuffs. No significant difference between the groups was recorded in arterial blood pressure and heart rate. In vitro data suggest that the lower the NaHCO3 injection volume, the greater the release of lidocaine across a low-pressure, high-volume cuff.
These data show benefits of using an alkalinized lidocaine-filled ETT cuff in combination with water-soluble gel lubrication in preventing post-intubation sore throat. |
| doi_str_mv | 10.1093/bja/aeh078 |
| format | Article |
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The work included an in vitro study of the diffusion of alkalinized lidocaine solution through the low-pressure, high-volume cuff of an ETT. We also performed a randomized controlled study (n=20 patients in each group) that included a group who received an alkalinized lidocaine-filled ETT cuff with lubrication of the tube using water-soluble gel (Group G), and two control groups who received an alkalinized lidocaine-filled cuff with ETT lubrication with water (Group W) or an air-filled cuff with ETT lubrication with water (Group C).
Water-soluble gel lubrication (Group G) produced a lower incidence of sore throat during the 24-h post-extubation period than lubrication with water alone in the cuffs filled with alkalinized lidocaine (Group W), and compared with the air control group. The ability of lidocaine to pass through the cuff of an ETT when water-soluble gel and/or water alone was used as a lubricant was similar, as determined by lidocaine plasma concentrations (Cmax 45 ng ml−1). Cough and restlessness before tracheal extubation were decreased in patients with the alkalinized lidocaine-filled cuffs compared with the air-filled cuffs. After extubation, nausea, vomiting, dysphonia and hoarseness were greater for patients with air-filled cuffs compared with the lidocaine-filled cuffs. No significant difference between the groups was recorded in arterial blood pressure and heart rate. In vitro data suggest that the lower the NaHCO3 injection volume, the greater the release of lidocaine across a low-pressure, high-volume cuff.
These data show benefits of using an alkalinized lidocaine-filled ETT cuff in combination with water-soluble gel lubrication in preventing post-intubation sore throat.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aeh078</identifier><identifier>PMID: 14970135</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adult ; alkalinization ; anaesthetics local ; anaesthetics local, lidocaine, alkalinization ; Anesthesia ; Anesthesia Recovery Period ; Anesthesia, General ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthetics, Local - administration & dosage ; Anesthetics, Local - blood ; Anesthetics, Local - chemistry ; Biological and medical sciences ; complications ; complications, sore throat ; Female ; Gels ; Humans ; Hydrogen-Ion Concentration ; intubation tracheal ; Intubation, Intratracheal - adverse effects ; lidocaine ; Lidocaine - administration & dosage ; Lidocaine - blood ; Lidocaine - chemistry ; Lubrication ; lubrication, water-soluble gel ; Male ; Medical sciences ; Middle Aged ; Non tumoral diseases ; Otorhinolaryngology. Stomatology ; Pharyngitis - etiology ; Pharyngitis - prevention & control ; Postoperative Complications - prevention & control ; Sodium Bicarbonate ; Solubility ; sore throat ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology ; water‐soluble gel</subject><ispartof>British journal of anaesthesia : BJA, 2004-03, Vol.92 (3), p.361-366</ispartof><rights>2004 British Journal of Anaesthesia</rights><rights>The Board of Management and Trustees of the British Journal of Anaesthesia 2004</rights><rights>2004 INIST-CNRS</rights><rights>Copyright British Medical Association Mar 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-ca3e3f542df0f76348b8d3a499935b6c98052856aa3598ee31913b0c5b859bc53</citedby><cites>FETCH-LOGICAL-c489t-ca3e3f542df0f76348b8d3a499935b6c98052856aa3598ee31913b0c5b859bc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,1586,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15511382$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14970135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Estebe, J.-P.</creatorcontrib><creatorcontrib>Delahaye, S</creatorcontrib><creatorcontrib>Le Corre, P</creatorcontrib><creatorcontrib>Dollo, G</creatorcontrib><creatorcontrib>Le Naoures, A</creatorcontrib><creatorcontrib>Chevanne, F</creatorcontrib><creatorcontrib>Ecoffey, C</creatorcontrib><title>Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena</title><title>British journal of anaesthesia : BJA</title><addtitle>Br. J. Anaesth</addtitle><addtitle>Br. J. Anaesth</addtitle><description>We sought to determine the benefits of using alkalinized lidocaine 40 mg to fill the cuff of a tracheal tube (ETT) in combination with water-soluble gel lubrication to prevent post-intubation sore throat.
The work included an in vitro study of the diffusion of alkalinized lidocaine solution through the low-pressure, high-volume cuff of an ETT. We also performed a randomized controlled study (n=20 patients in each group) that included a group who received an alkalinized lidocaine-filled ETT cuff with lubrication of the tube using water-soluble gel (Group G), and two control groups who received an alkalinized lidocaine-filled cuff with ETT lubrication with water (Group W) or an air-filled cuff with ETT lubrication with water (Group C).
Water-soluble gel lubrication (Group G) produced a lower incidence of sore throat during the 24-h post-extubation period than lubrication with water alone in the cuffs filled with alkalinized lidocaine (Group W), and compared with the air control group. The ability of lidocaine to pass through the cuff of an ETT when water-soluble gel and/or water alone was used as a lubricant was similar, as determined by lidocaine plasma concentrations (Cmax 45 ng ml−1). Cough and restlessness before tracheal extubation were decreased in patients with the alkalinized lidocaine-filled cuffs compared with the air-filled cuffs. After extubation, nausea, vomiting, dysphonia and hoarseness were greater for patients with air-filled cuffs compared with the lidocaine-filled cuffs. No significant difference between the groups was recorded in arterial blood pressure and heart rate. In vitro data suggest that the lower the NaHCO3 injection volume, the greater the release of lidocaine across a low-pressure, high-volume cuff.
These data show benefits of using an alkalinized lidocaine-filled ETT cuff in combination with water-soluble gel lubrication in preventing post-intubation sore throat.</description><subject>Adult</subject><subject>alkalinization</subject><subject>anaesthetics local</subject><subject>anaesthetics local, lidocaine, alkalinization</subject><subject>Anesthesia</subject><subject>Anesthesia Recovery Period</subject><subject>Anesthesia, General</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Anesthetics, Local - blood</subject><subject>Anesthetics, Local - chemistry</subject><subject>Biological and medical sciences</subject><subject>complications</subject><subject>complications, sore throat</subject><subject>Female</subject><subject>Gels</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>intubation tracheal</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>lidocaine</subject><subject>Lidocaine - administration & dosage</subject><subject>Lidocaine - blood</subject><subject>Lidocaine - chemistry</subject><subject>Lubrication</subject><subject>lubrication, water-soluble gel</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non tumoral diseases</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Pharyngitis - etiology</subject><subject>Pharyngitis - prevention & control</subject><subject>Postoperative Complications - prevention & control</subject><subject>Sodium Bicarbonate</subject><subject>Solubility</subject><subject>sore throat</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><subject>water‐soluble gel</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90c-L1DAUwPEiijuuXvwDJAh6EOomTdMkx2VRV1hRFpXFS3hNX2cym6Zj0oo__nkzdHBAxFMO-STvwbcoHjP6klHNz9otnAFuqFR3ihWrJSsbKdndYkUplSXVrDopHqS0pZTJSov7xQmrtaSMi1Xx69zfgnfB_YTJjYGMPXFhilDaue-Jd91owQUkEDoyJ9zfr9ETP7fR2eXJLo4T2onAOss0kfzabhA8meYWSxe62WJHcMC4xmCR7DYYxgEDPCzu9eATPjqcp8Wn168-XlyWV-_fvL04vyptrfRUWuDIe1FXXU972fBatarjUGutuWgbqxUVlRINABdaIXKmGW-pFa0SurWCnxbPl3_zpl9nTJMZXLLoPQQc52QUZU3Nap7h07_gdpxjyLsZpqWuuGhURi8WZOOYUsTe7KIbIP4wjJp9D5N7mKVHxk8OP87tgN2RHgJk8OwAIFnwfYRgXTo6IRjjqjq6cd79f2C5OJcm_P5HQrw1jeRSmMubL4a_uxafb64b8yH7evGYA3xzGE2ybp-pczFHNd3o_jXmN6wCwrI</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>Estebe, J.-P.</creator><creator>Delahaye, S</creator><creator>Le Corre, P</creator><creator>Dollo, G</creator><creator>Le Naoures, A</creator><creator>Chevanne, F</creator><creator>Ecoffey, C</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20040301</creationdate><title>Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena</title><author>Estebe, J.-P. ; Delahaye, S ; Le Corre, P ; Dollo, G ; Le Naoures, A ; Chevanne, F ; Ecoffey, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-ca3e3f542df0f76348b8d3a499935b6c98052856aa3598ee31913b0c5b859bc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>alkalinization</topic><topic>anaesthetics local</topic><topic>anaesthetics local, lidocaine, alkalinization</topic><topic>Anesthesia</topic><topic>Anesthesia Recovery Period</topic><topic>Anesthesia, General</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Anesthetics, Local - blood</topic><topic>Anesthetics, Local - chemistry</topic><topic>Biological and medical sciences</topic><topic>complications</topic><topic>complications, sore throat</topic><topic>Female</topic><topic>Gels</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>intubation tracheal</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>lidocaine</topic><topic>Lidocaine - administration & dosage</topic><topic>Lidocaine - blood</topic><topic>Lidocaine - chemistry</topic><topic>Lubrication</topic><topic>lubrication, water-soluble gel</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non tumoral diseases</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Pharyngitis - etiology</topic><topic>Pharyngitis - prevention & control</topic><topic>Postoperative Complications - prevention & control</topic><topic>Sodium Bicarbonate</topic><topic>Solubility</topic><topic>sore throat</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><topic>water‐soluble gel</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Estebe, J.-P.</creatorcontrib><creatorcontrib>Delahaye, S</creatorcontrib><creatorcontrib>Le Corre, P</creatorcontrib><creatorcontrib>Dollo, G</creatorcontrib><creatorcontrib>Le Naoures, A</creatorcontrib><creatorcontrib>Chevanne, F</creatorcontrib><creatorcontrib>Ecoffey, C</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Estebe, J.-P.</au><au>Delahaye, S</au><au>Le Corre, P</au><au>Dollo, G</au><au>Le Naoures, A</au><au>Chevanne, F</au><au>Ecoffey, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>Br. J. Anaesth</stitle><addtitle>Br. J. Anaesth</addtitle><date>2004-03-01</date><risdate>2004</risdate><volume>92</volume><issue>3</issue><spage>361</spage><epage>366</epage><pages>361-366</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>We sought to determine the benefits of using alkalinized lidocaine 40 mg to fill the cuff of a tracheal tube (ETT) in combination with water-soluble gel lubrication to prevent post-intubation sore throat.
The work included an in vitro study of the diffusion of alkalinized lidocaine solution through the low-pressure, high-volume cuff of an ETT. We also performed a randomized controlled study (n=20 patients in each group) that included a group who received an alkalinized lidocaine-filled ETT cuff with lubrication of the tube using water-soluble gel (Group G), and two control groups who received an alkalinized lidocaine-filled cuff with ETT lubrication with water (Group W) or an air-filled cuff with ETT lubrication with water (Group C).
Water-soluble gel lubrication (Group G) produced a lower incidence of sore throat during the 24-h post-extubation period than lubrication with water alone in the cuffs filled with alkalinized lidocaine (Group W), and compared with the air control group. The ability of lidocaine to pass through the cuff of an ETT when water-soluble gel and/or water alone was used as a lubricant was similar, as determined by lidocaine plasma concentrations (Cmax 45 ng ml−1). Cough and restlessness before tracheal extubation were decreased in patients with the alkalinized lidocaine-filled cuffs compared with the air-filled cuffs. After extubation, nausea, vomiting, dysphonia and hoarseness were greater for patients with air-filled cuffs compared with the lidocaine-filled cuffs. No significant difference between the groups was recorded in arterial blood pressure and heart rate. In vitro data suggest that the lower the NaHCO3 injection volume, the greater the release of lidocaine across a low-pressure, high-volume cuff.
These data show benefits of using an alkalinized lidocaine-filled ETT cuff in combination with water-soluble gel lubrication in preventing post-intubation sore throat.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>14970135</pmid><doi>10.1093/bja/aeh078</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult alkalinization anaesthetics local anaesthetics local, lidocaine, alkalinization Anesthesia Anesthesia Recovery Period Anesthesia, General Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthetics, Local - administration & dosage Anesthetics, Local - blood Anesthetics, Local - chemistry Biological and medical sciences complications complications, sore throat Female Gels Humans Hydrogen-Ion Concentration intubation tracheal Intubation, Intratracheal - adverse effects lidocaine Lidocaine - administration & dosage Lidocaine - blood Lidocaine - chemistry Lubrication lubrication, water-soluble gel Male Medical sciences Middle Aged Non tumoral diseases Otorhinolaryngology. Stomatology Pharyngitis - etiology Pharyngitis - prevention & control Postoperative Complications - prevention & control Sodium Bicarbonate Solubility sore throat Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology water‐soluble gel |
| title | Alkalinization of intra-cuff lidocaine and use of gel lubrication protect against tracheal tube-induced emergence phenomena |
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