Authors: Wang, Keyan et al.
Anesthesia & Analgesia 141(4):818–827, October 2025.DOI: 10.1213/ANE.0000000000007560
This randomized clinical trial evaluated whether combining dexmedetomidine with lidocaine spray could better suppress the cough reflex during extubation in female thyroidectomy patients. A total of 180 patients were divided into three groups: dexmedetomidine + lidocaine (Dex-Lido), lidocaine alone (Lido), and normal saline (Control). The sprays were applied to the supraglottic, glottic, and subglottic areas before intubation.
Cough during extubation occurred significantly less often in the Dex-Lido group (23%) compared with both the Lido (47%) and Control (70%) groups. The combination also reduced cough severity and postoperative sore throat while stabilizing hemodynamic parameters. The study found no significant increase in adverse effects such as nausea, vomiting, or delayed awakening.
The authors conclude that topical administration of dexmedetomidine combined with lidocaine provides a synergistic antitussive effect during extubation and enhances postoperative comfort for thyroidectomy patients.
What You Should Know
• Dexmedetomidine + lidocaine spray before intubation sharply reduces extubation cough incidence and severity.
• The combination improves hemodynamic stability and reduces sore throat after thyroid surgery.
• This method offers a simple, low-risk strategy to improve emergence quality, particularly for cases where coughing could increase bleeding or compromise wound integrity.
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