Kanumetta R, Vishal P, Sri Soumya R, et al.
Cureus 17(8): e89734. doi:10.7759/cureus.89734
This randomized, prospective study compared the effects of inflating endotracheal tube (ETT) cuffs with air versus alkalinized lignocaine on cardiovascular responses during intubation. Sixty ASA I–II adult patients undergoing elective surgery were divided into two equal groups. Group A received air inflation; Group B received 2% lignocaine alkalinized with sodium bicarbonate in a 19:1 ratio. Hemodynamic parameters (HR, SBP, DBP, MAP) were recorded at baseline and at 1, 3, 5, and 10 minutes post-intubation.
Results showed significantly attenuated increases in HR and BP in the lignocaine group at all time points, with the most pronounced effect at 1 minute post-intubation (e.g., HR: 103.4 bpm in Group A vs. 91.2 bpm in Group B; p < 0.001). No adverse events were reported. The authors attribute the effect to lignocaine’s ability to diffuse across the cuff, anesthetizing the tracheal mucosa and blunting reflex sympathetic responses.
The study concludes that intracuff alkalinized lignocaine is a simple, effective, and noninvasive method to improve hemodynamic stability during intubation, especially in patients at cardiovascular risk. Limitations include a small sample size, short observation period, and exclusion of higher-risk populations. The authors recommend larger, multicenter trials with extended follow-up and inclusion of postoperative airway morbidity assessments.
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