Iranian Heart Journal

Iranian Heart Journal

Effects of Using Intravenous Lidocaine on Reducing the Complications of Tracheal Tube Removal After Cardiac Surgery: A Randomized Clinical Trial

Document Type : Original Article

Authors
Rasoul Azarfarin 1
Rasool Ferasatkish 2
Ziae Totonchi 2
Abdolreza Dayani 2
Hassan Tatari 2
Saied Amniati 3
1 Cardio-Oncology Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
3 Rasool Akarm Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
Abstract
Background: Coughing during anesthesia or extubation is a probable event that can cause hemodynamic changes due to an increase in chest pressure or the stimulation of the adrenergic system. We aimed to compare the effects of IV lidocaine with those of IV normal saline (as a placebo) on diminishing the incidence of coughs and sore throats, laryngospasms, and hemodynamic changes during tracheal extubation in the ICU after cardiac surgery.
 
Methods: The present randomized clinical trial assigned 50 candidates for simple cardiac valve or coronary bypass surgery to 2 groups (each group =25) to receive IV lidocaine or a placebo before tracheal tube removal after cardiac surgery in the ICU. Hemodynamic changes, the level of consciousness-restlessness (RASS), and the incidence of coughs were evaluated in both study groups. Four patients in the lidocaine group and 5 in the control group were lost to follow-up. Finally, 21 patients in the lidocaine group and 20 patients in the control group were analyzed.
 
Results: The rates of hemodynamic changes in the 2 groups were not statistically different. The changes in the level of consciousness based on the RASS were not significant in the 2 groups. The incidence of coughs based on the mentioned 3 criteria showed a statistically significant difference between the lidocaine and placebo groups.
 
Conclusions: IV lidocaine after cardiac surgery can be part of the weaning and extubation process without hemodynamic complications to reduce the incidence of coughs. (Iranian Heart Journal 2023; 24(3): 45-53)
Keywords
Anesthesia
Lidocaine
Cardiac surgery
Cough
Extubation
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Iranian Heart Journal
Volume 24, Issue 3
Summer 2023
Pages 45-53