Change in 4% lidocaine Instillation in the endotracheal tube (ETT) before and after surgery in patients undergoing surgery under general anesthesia.

Umar  Farooq; Sheikh Muhammad  Ahmed Tariq; Zafar Ullah  Khan; Muhammad Umer  Iqbal Butt; Ahmed Masood  Qureshi; Muhammad  Tayyeb

doi:10.54112/bcsrj.v6i10.1900

Authors

Umar Farooq Queen Elizabeth Hospital, Birmingham, UK
Sheikh Muhammad Ahmed Tariq National Hospital, Lahore, Pakistan
Zafar Ullah Khan Mercy University Hospital, Cork, Ireland
Muhammad Umer Iqbal Butt Jinnah Hospital, Lahore, Pakistan
Ahmed Masood Qureshi Nawaz Sharif Social Security Teaching Hospital, Lahore, Pakistan
Muhammad Tayyeb College of Medical Technology, BKMC, Swabi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i10.1900

Keywords:

Lidocaine, Endotracheal tube, Post-operative sore throat, Airway complications, General anesthesia

Abstract

Post-operative sore throat and airway-related complications are common after general anesthesia with endotracheal intubation. Lidocaine instillation into the endotracheal tube cuff and lumen has been proposed to reduce these complications, but evidence remains variable. Objective: To evaluate the effect of 4% lidocaine instillation on post-operative airway morbidity in patients undergoing surgery under general anesthesia. Methods: A quasi-experimental trial was conducted on 130 patients undergoing various elective surgeries under general anesthesia with endotracheal intubation. Patients were divided into two groups: the lidocaine instillation group (n = 65) and the non-lidocaine group (n = 65). Demographic and intraoperative data were recorded. Airway complications, including sore throat, hoarseness, cough, dysphagia, and laryngospasm, were assessed pre-operatively and post-operatively. Logistic regression analysis was performed to identify predictors of post-operative sore throat. Results: Post-operative airway complications increased significantly compared to pre-operative status, with sore throat (29.2%), cough (32.3%), hoarseness (20.0%), dysphagia (13.8%), and laryngospasm (6.2%) observed after surgery (all p < 0.05). Compared to the non-lidocaine group, the lidocaine group had significantly lower incidence of sore throat (18.5% vs. 40.0%, p = 0.010), hoarseness (12.3% vs. 27.7%, p = 0.032), cough (15.4% vs. 43.1%, p = 0.001), and dysphagia (6.2% vs. 21.5%, p = 0.018). Regression analysis showed that age ≥40 years, female sex, intubation duration ≥2 hours, cuff pressure >30 cmH₂O, and absence of lidocaine instillation were independent predictors of sore throat. Conclusion: Instillation of 4% lidocaine in the endotracheal tube significantly reduces the incidence of common post-operative airway complications. Careful control of cuff pressure and limiting intubation duration further mitigates risk. These findings support the routine use of lidocaine instillation as a simple and effective strategy to improve post-anesthesia airway outcomes.

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