Vegetable gum based gel lubrication of endotracheal tube cuffs improves efficacy of alkalinized intracuff lignocaine in preventing postoperative sore throat: A randomized controlled study

Abstract

Background and aims: In order to reduce endotracheal tube (ETT) induced emergence phenomenon at extubation which involves postoperative sore throat (POST), cough, hoarseness, dysphagia and hemodynamic changes, we evaluated the efficacy of vegetable gum based (VGB) Lubic gel lubrication alone or in combination with 4% intracuff alkalinized lignocaine (IAL). The vegetable gums in the gel appear to be of special significance.

Methodology: 100 patients undergoing surgical procedures under general anesthesia were randomly allocated to 4 groups of 25 each. In Group C (control group) patients, the ETT cuffs were inflated with air and lubricated with normal saline. In Group G, the cuffs were inflated with air, while in Group L and LG, cuffs were filled with IAL. The Group G and LG cuffs were lubricated with VGB lubricant gel while Group L cuffs were lubricated with normal saline. During the post-extubation period POST was studied using Visual Analogue Scale (VAS) at 15 min, 1, 2, 3 and 24 h. Incidence of cough, dysphagia, hoarseness and hemodynamic changes was recorded and compared.

Results: The mean VAS scores for POST were found to be the least in Group LG (12.6 ± 7.08) compared to Groups C (33.8 ± 9.38), G (32.52 ± 2.11) and Group L (21.6 ± 12.30) over 24 h. Incidence of cough, dysphagia, hoarseness and hemodynamic changes was least in Group LG compared to others.