Comparative study of endotracheal tube cuff inflation with air versus alkalinized lidocaine on hemodynamic response during extubation

The increased use of cuffed endotracheal tube during general anaesthesia has been associated with increased incidences of hemodynamic stress leading to tachycardia and hypertension during emergence from general anaesthesia. Hence it is planned to conduct a study inflating the endotracheal tube cuff with air as compared to inflation with 2% alkalinized lidocaine during intubation to observe the changes in hemodynamic stress response during extubation. This study aimed to compare the effects of endotracheal tube cuff inflation with air versus 2% alkalinized lidocaine on hemodynamic stability during extubation (primary outcome) and to assess associated side effects (secondary outcome). This Randomised prospective observational study was done on 40 patients between the age group of 18 to 65 years of both gender belonging to American Society of Anaesthesiologists (ASA) physical status 1 and 2 undergoing elective surgeries requiring general anaesthesia. They were separated into Group A – cuff inflated with air and Group L – cuff inflated with alkalinized lidocaine prepared by taking 9cc of 2% lidocaine and adding 1cc of sodium bicarbonate and using approximately 4-5 cc to inflate the cuff. Hemodynamic changes at baseline, induction, intraoperatively, during extubation and post-extubation were recorded. Haemodynamic responses were monitored at extubation & 2,4,6,8,10,15 minutes after extubation showed better hemodynamic stability in Group L than Group A. The study suggested that endotracheal tube cuff inflated with alkalinized lidocaine have shown better hemodynamic stress response during extubation and post-extubation.