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Intracuff local anesthetic to reduce postoperative sore throat: a randomized clinical trial

  • Megan McLachlanEmail author
  • Jonathan Gamble
  • Jennifer M. O’Brien
  • William P. McKay
  • Jagmeet S. Bajwa
Correspondence
  • 17 Downloads

To the Editor,

Postoperative sore throat (POST) following tracheal intubation is reported in 30–70% of patients,1 and is ranked by patients as the sixth most important postoperative complication.2 Instillation of a short-acting local anesthetic, lidocaine, in the endotracheal tube (ETT) cuff reduced postoperative sore throat at one and 24 hr.3 We hypothesized intracuff ropivacaine, a longer acting local anesthetic with a relatively safe cardiovascular toxicity profile, would reduce the severity and incidence of POST on postoperative day one (POD 1).

Following Research Ethics Board approval (Bio18-09 2018, March) and protocol registration (NCT03563963), we conducted a randomized blinded multisite clinical trial comparing POST between three groups: 1) ETT cuff inflated with ropivacaine 0.5%, 2) ETT cuff inflated with lidocaine 2%, and 3) ETT cuff inflated with air (standard care). Informed consent was obtained from those participants aged >18 yr, with American Society of...

Notes

Acknowledgements

The authors gratefully acknowledge the many participants involved in this study and the Saskatchewan Health Authority for their support of this research.

Competing interest

None.

Funding

College of Medicine University of Saskatchewan.

Editorial responsibility

This submission was handled by Dr. Gregory L. Bryson, Deputy Editor-in-Chief, Canadian Journal of Anesthesia.

Data availability statement

Raw data available at: megan.mclachlan@usask.ca.

Reproducible science

Full protocol available at megan.mclachlan@usask.ca.

Trial registration

www.clinicaltrials.gov, NCT03563963; registered 20 June, 2018.

References

  1. 1.
    Tanaka Y, Nakayama T, Nishimori M, Tsujimura Y, Kawaguchi M, Sato Y. Lidocaine for preventing postoperative sore throat. Cochrane Database Syst Rev 2015; 7: CD004081.Google Scholar
  2. 2.
    Jenkins K, Grady D, Wong J, Correa R, Armanious S, Chung F. Post-operative recovery: day surgery patients’ preferences. Br J Anaesth 2001; 86: 272-4.CrossRefGoogle Scholar
  3. 3.
    Lam F, Lin YC, Tsai HC, Chen TL, Tam KW, Chen CY. Effect of intracuff lidocaine on postoperative sore throat and the emergence phenomenon: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2015; DOI:  https://doi.org/10.1371/journal.pone.0136184.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kumar RD, Hirsh NP. Clinical evaluation of stethoscope-guided inflation of tracheal tube cuffs. Anaesthesia 2011; 66: 1012-6.CrossRefGoogle Scholar
  5. 5.
    Menck T, Echternach M, Kleinschmidt S, et al. Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial. Anesthesiology 2003; 98: 1049-56.CrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  • Megan McLachlan
    • 1
    Email author
  • Jonathan Gamble
    • 1
  • Jennifer M. O’Brien
    • 1
  • William P. McKay
    • 1
  • Jagmeet S. Bajwa
    • 1
  1. 1.Department of Anesthesiology, Perioperative Medicine and Pain ManagementUniversity of SaskatchewanSaskatoonCanada

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