Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia

Abstract Background Endotracheal tube with an inflated cuff was used to manage and maintain the airway during general anesthesia in children. When the lateral pressure exerted by an inflated Endotracheal tube cuff on tracheal mucosa exceeds capillary perfusion pressure, patients may complain of coug...

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Main Authors: Biniam Assefa, Hirbo Samuel, Fissiha Fentie, Tenbite Daniel, Assefa Hika, Bacha Aberra, Belete Alemu
Format: Article
Language:English
Published: BMC 2022-11-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-022-01868-2
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author Biniam Assefa
Hirbo Samuel
Fissiha Fentie
Tenbite Daniel
Assefa Hika
Bacha Aberra
Belete Alemu
author_facet Biniam Assefa
Hirbo Samuel
Fissiha Fentie
Tenbite Daniel
Assefa Hika
Bacha Aberra
Belete Alemu
author_sort Biniam Assefa
collection DOAJ
description Abstract Background Endotracheal tube with an inflated cuff was used to manage and maintain the airway during general anesthesia in children. When the lateral pressure exerted by an inflated Endotracheal tube cuff on tracheal mucosa exceeds capillary perfusion pressure, patients may complain of cough, sore throat, and hoarseness in the postoperative period. This study aimed to assess the effect of a tracheal tube cuff filled with alkalinized lidocaine versus air on hemodynamic parameter changes during extubation and post-operative airway morbidity in children. Methods Institutional based observational prospective cohort study was conducted among 56 elective children; aged 3–13 years, who underwent operation under general anesthesia with cuffed endotracheal intubation for greater than one hour by grouping into the air (group1) and alkalinized Lidocaine (group2) at Tikur Anbessa specialized Hospital. Hemodynamic parameters (Heart rate and Blood pressure) and other variables were measured starting from 5 min before extubation to 24th hours after extubation of the endotracheal tube. A Comparison of numerical variables between study group was done with an independent t-test. Data were expressed in terms of mean ± standard deviation. Categorical data were assessed by Chi-square tests. Results Postoperative Sore throat was lower in alkalinized lidocaine group compared to the air group. The mean heart rate at five minutes after extubation was significantly lower in alkalinized lidocaine group (107.29 ± 6.457 beat per minute (bpm)) compared to the air group (122.04 ± 8.809 bpm), with P ≤ 0.001. Systolic blood pressure was also significantly lower in alkalinized lidocaine group (99.64 ± 8.434 millimeters of mercury (mmHg)) compared to the air group (108.21 ± 11.902 mmHg), p = 0.016 at five minutes after extubation. Conclusion Alkalinized lidocaine inflated tracheal tubes have shown improved hemodynamic and laryngotracheal morbidities in children.
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spelling doaj.art-958a3afc329445faa674c6da02d65df02023-06-18T11:23:15ZengBMCBMC Anesthesiology1471-22532022-11-012211810.1186/s12871-022-01868-2Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, EthiopiaBiniam Assefa0Hirbo Samuel1Fissiha Fentie2Tenbite Daniel3Assefa Hika4Bacha Aberra5Belete Alemu6Department of Anesthesia, College of Medicine and Health Sciences, Addis Ababa UniversityDepartment of Anesthesia, College of Medicine and Health Sciences, Addis Ababa UniversityDepartment of Anesthesia, College of Medicine and Health Sciences, Addis Ababa UniversityDepartment of Anesthesia, College of Medicine and Health Sciences, Addis Ababa UniversityDepartment of Anesthesia, College of Health Science, Aksum UniversityDepartment of Anesthesia, College of Health Science, Aksum UniversityDepartment of Anesthesia, College of Health Science, Hawassa UniversityAbstract Background Endotracheal tube with an inflated cuff was used to manage and maintain the airway during general anesthesia in children. When the lateral pressure exerted by an inflated Endotracheal tube cuff on tracheal mucosa exceeds capillary perfusion pressure, patients may complain of cough, sore throat, and hoarseness in the postoperative period. This study aimed to assess the effect of a tracheal tube cuff filled with alkalinized lidocaine versus air on hemodynamic parameter changes during extubation and post-operative airway morbidity in children. Methods Institutional based observational prospective cohort study was conducted among 56 elective children; aged 3–13 years, who underwent operation under general anesthesia with cuffed endotracheal intubation for greater than one hour by grouping into the air (group1) and alkalinized Lidocaine (group2) at Tikur Anbessa specialized Hospital. Hemodynamic parameters (Heart rate and Blood pressure) and other variables were measured starting from 5 min before extubation to 24th hours after extubation of the endotracheal tube. A Comparison of numerical variables between study group was done with an independent t-test. Data were expressed in terms of mean ± standard deviation. Categorical data were assessed by Chi-square tests. Results Postoperative Sore throat was lower in alkalinized lidocaine group compared to the air group. The mean heart rate at five minutes after extubation was significantly lower in alkalinized lidocaine group (107.29 ± 6.457 beat per minute (bpm)) compared to the air group (122.04 ± 8.809 bpm), with P ≤ 0.001. Systolic blood pressure was also significantly lower in alkalinized lidocaine group (99.64 ± 8.434 millimeters of mercury (mmHg)) compared to the air group (108.21 ± 11.902 mmHg), p = 0.016 at five minutes after extubation. Conclusion Alkalinized lidocaine inflated tracheal tubes have shown improved hemodynamic and laryngotracheal morbidities in children.https://doi.org/10.1186/s12871-022-01868-2Air inflationsAlkalinized LidocaineCuff pressureEndotracheal tubeLaryngotracheal morbiditiesTracheal mucosa
spellingShingle Biniam Assefa
Hirbo Samuel
Fissiha Fentie
Tenbite Daniel
Assefa Hika
Bacha Aberra
Belete Alemu
Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia
BMC Anesthesiology
Air inflations
Alkalinized Lidocaine
Cuff pressure
Endotracheal tube
Laryngotracheal morbidities
Tracheal mucosa
title Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia
title_full Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia
title_fullStr Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia
title_full_unstemmed Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia
title_short Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia
title_sort effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post operative airway morbidities in children prospective observational cohort study ethiopia
topic Air inflations
Alkalinized Lidocaine
Cuff pressure
Endotracheal tube
Laryngotracheal morbidities
Tracheal mucosa
url https://doi.org/10.1186/s12871-022-01868-2
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