• U M Klemola, L Saarnivaara, and H Yrjölä.
• Department of Anaesthesia, Otolaryngological Hospital, University of Helsinki, Finland.
• Eur J Anaesthesiol. 1988 Nov 1;5(6):391-9.

AbstractThe effects of laryngeal lignocaine spray and/or lignocaine jelly as lubricants were studied on the incidence of sore throat, hoarseness, or tracheal irritability as evidenced by either a tendency to cough or frank coughing after intubation with a Sensiv tube (Searle Medical Products). Pressure in the medium-volume, low-pressure cuff was controlled and kept below 2.5 kPa (25 cmH2O) during anaesthesia. The side-effects of 94 surgical patients were recorded in a double-blind manner in the recovery room and on the first post-operative day. The lowest number of patients (62%) with side-effects was found in the control group and the greatest (95%) after the combination of lignocaine jelly and spray (P less than 0.05). The number of side-effects after lignocaine jelly alone was 85% and after the spray alone 68%. Women were more prone to have side-effects, especially sore throat and hoarseness, than men (P less than 0.05). Induced hypotension did not increase the incidence of side-effects. Endotracheal cuff pressures were also studied in 114 patients during N2O-O2 anaesthesia and in 54 patients after the replacement of N2O with nitrogen. The minimum occluding pressure required was 1 kPa (10 cmH2O). In 42% of the patients receiving N2O a limiting value of 2.5 kPa (25 cmH2O) was reached during anesthesia in a mean time of 74 min (range 25-180 min). After the replacement of N2O with nitrogen, the cuff pressure decreased from 1.8 kPa (18 cmH2O) to 0.7 kPa (7 cmH2O) over 40 min. It is concluded that lignocaine jelly with the use of a spray significantly increases post-operative side-effects.

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