Effect of injecting alkalinized lidocaine into tracheal tube cuff on responses to extubation in pediatric patients

Objective To evaluate the effect of injecting alkalinized lidocaine into the tracheal tube cuff on the responses to extubation in pediatric patients. Methods One hundred and twenty-six pediatric patients, aged 3-13 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective abdominal surgery under general anesthesia requiring oral tracheal intubation, were divided into 3 groups (n=42 each) using a random number table: control group (group C), normal saline group (group NS) and alkalinized lidocaine group (group L). Air was injected into the tracheal tube cuff in group C. Normal saline was injected into the tracheal tube cuff in group NS.Alkalinized lidocaine was injected into the tracheal tube cuff in group L. Cuff pressure was monitored and maintained below 20 cmH2O.The differences in mean arterial pressure (△MAP) and heart rate (△HR) immediately after stopping inhalation of anesthetics and immediately after extubation were calculated.The response to extubation was defined as △MAP or △HR>20% of the baseline value and/or development of moderate and severe bucking and agitation.The development of coughing, hoarseness and sore throat during the period in postanesthesia care unit and the period from being discharged from postanesthesia care unit until 8 h after extubation were recorded. Results Compared with group C and group NS, the incidence of response to extubation and sore throat was significantly decreased (P 0.05). The volume of the alkalized lidocaine solution in the cuff was(4.2±2.3)ml[(60±33) mg] in group L. No cuff damage was found in three groups. Conclusion Injecting alkalinized lidocaine into the tracheal tube cuff can safely and effectively inhibit responses to extubation and is helpful in improving outcomes in pediatric patients. Key words: Lidocaine; Intubation, intratracheal; Child; Postoperative complications