Efficacy of compound lidocaine cream combined with dyclonine solution in improving adverse reactions of endotracheal intubation

Objective To explore the efficacy of compound lidocaine cream combined with appropriate dose of dyclonine solution in improving adverse reactions of endotracheal intubation.

Methods A total of 272 patients with laparoscopic cholecystectomy were selected and randomly divided into 4 groups, with 68 cases in each group.Group A used normal saline to lubricate the surface of endotracheal tube; groups B, C and D used 1, 3 and 5 g compound lidocaine cream to daubon cuff and 10 cm in front of endotracheal tube respectively.Patients in each group took 5 mL dyclonine solution orally for 5 minutes before operation.Heart rate (HR) and mean arterial pressure (MAP) at the time points of before anesthesia induction (T₀), after intubation (T₁), at beginning of operation (T₂), after awakening (T₃) and 5 minutes after extubation (T₄) were recorded; the anesthesia time, operation time, awakening time and tube carrying time after awakening were recorded; the incidence rates of choking cough and agitation at extubation were recorded, and the scores of sore throat, hoarseness and cough at 6 and 24 hours after operation were evaluated.

Results There were no significant differences in HR and MAP at each time point among the four groups (P>0.05).There were no significant differences in anesthesia time, operation time, awakening time and tube carrying time after awakening among the four groups (P>0.05).There was a significant difference in incidence of choking at extubation between group C (the lowest) and groups A, B (P < 0.05);there was a significant difference in agitation rate in groups C and D compared with groups A and B (P < 0.05).There was no significant difference in postoperative complications between group A and B (P>0.05);the incidence rates of pharyngeal pain and hoarseness in group C and D were lower than that in group A, and the incidence of cough in group D was significantly higher than that in group C (P < 0.05).

Conclusion Compound lidocaine cream combined with dyclonine solution can effectively alleviate glottic injury and tracheal stress response, and reduce laryngoscope exposure andstress stimulation due to endotracheal tube implantation.