• Laura E Wetzel, Amy L Ancona, Andrew S Cooper, Amy J Kortman, Gayle B Loniewski, and Lynn L Lebeck.
• University of Michigan-Flint/Hurley Medical Center Anesthesia Program, USA.
• AANA J. 2008 Apr 1;76(2):105-8.

AbstractCoughing commonly occurs in patients emerging from general endotracheal anesthesia and is prominent in smokers due to underlying airway irritation. Clinical techniques used to mitigate emergence coughing include intravenous narcotics, intravenous or topical lidocaine, and deep extubation. Reduction of coughing by instilling lidocaine into the endotracheal tube cuff has been shown to be effective in long cases. Research has not confirmed efficacy of this technique in short cases. Does administration of intracuff lidocaine decrease coughing during emergence of smokers in short cases requiring general endotracheal anesthesia? This study was a randomized, double blind, posttest-only design that included 38 patients. Investigators recruited the subjects, obtained consent, and provided a syringe containing 5 mL of 4% lidocaine or 5 mL of saline to the anesthesia provider. At time of intubation, the provider injected the contents of the syringe into the endotracheal tube cuff. The control group received 5 mL of saline, and the experimental group received 5 mL of 4% lidocaine. On emergence, the anesthesia provider counted and recorded the number of coughs before awake extubation. This study did not show a correlation between use of intracuff lidocaine and a decrease in emergence coughing in procedures lasting less than 1.5 hours in patients who smoke.

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