• F Chevanne and P Le Corre.
• Department of anesthesiology and pain medicine, university of Washington school medicine, Harborview medical center, Box 359724, 325 Ninth Avenue, Seattle, WA 98104, États-Unis; Laboratoire de pharmacie galénique et biopharmacie, université de Rennes 1, 2, avenue Pr Léon-Bernard, 35043 Rennes, France. Electronic address: estebe@uw.edu.
• Ann Fr Anesth Reanim. 2014 Apr 1;33(4):e73-7.

ObjectivesEndotracheal tube (ETT) and its inflated cuff are likely to induce specific reactivity at the emergence time. In ICU, the tolerance of the ETT cuff could be a part of patient agitation and increased of sedation.Materials And MethodsUsing specific ICU ETT cuff (thin polyurethane cuff), we perform an in vitro evaluation of diffusion of lidocaine and alkalinized lidocaine (L-B) across the PU cuff for a long duration. We evaluate the safety of this procedure by a daily injection into the cuff.ResultsWith lidocaine alone, we observed a low rate of diffusion through the cuff (<8% over 24h), whereas the L-B solution had a high diffusion (>90% over 24h). The released profiles were similar from day 0 to day 8, and no cuff rupture was reported over the 8-day study.ConclusionThe safety, controlled release, and lack of deleterious effects on cuff membrane were confirmed. In case of unexpected cuff rupture, an adequate determination of the mixture allows to obtain a safe solution with the achievement of a physiological pH (7.4) and the small dose of lidocaine (40 mg).Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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