Comparative study of the Cuff Pressure between Air and Alkalinized Lignocaine in General Anaesthesia

Safeeba Burveen, H (2013) Comparative study of the Cuff Pressure between Air and Alkalinized Lignocaine in General Anaesthesia. Masters thesis, Madurai Medical College, Madurai.

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Abstract

This study was carried out at Govt. Rajaji hospital, Madurai in 50 patients of age 18-65 years of ASA I,II,&III who underwent abdominal &breast surgeries under general anaesthesia with N2O.They were divided into two groups 25 patients in each group. GROUP A:Inflated with air upto pressure of 20 cm of water. GROUP L: Inflated with alkalinized lignocaine(2% lignocaine : sodium bicarbonate 19:1 up to pressure of 20 cm of water . All Patients were pre medicated with Inj. Glycopyrolate 0.2 mg intramuscularly 45 minutes before surgery. Monitors were connected. Intravenous cannula secured and connected to i. v fluids. Patient were pre oxygenated with 100% O2 for 3 minutes. Patient is induced with Inj. fentanyl 2 micrograms/kg, Inj. propofol 2mg/Kg i.v, Inj. Atracurium 0.5 mg/kg and intubated with 7.5 mm(females), 8mm(males) endotracheal tube. Endotracheal tube was inflated according to study group. Bilateral air entry checked and connected to closed circuit. Patient is maintained with N2O : O2 2:2, Inj. fentanyl 1 micrograms/kg, inj. atracurium in titrated doses Baseline cuff pressure before N2O administration is monitored. Cuff pressure is recorded every 30 minutes thereafter .At the end of surgery, cuff pressure, tube tolerance, volume of air/alkalinized lignocaine deflated during extubation were noted. After adequate attempts of respirations, patient is reversed with inj.Glycopyrolate 10 mics/kg , inj. neostigmine 40 mics/kg and extubated after deflation of the cuff. INTRAOPERATIVELY following parameters were monitored. 1. PR, BP, SPO, ETCO2, Cuff pressure were noted before nitrous oxide administration, and every 30 minutes till the end of surgery. 2. Tube tolerance, BP, PR, volume of air /lignocaine deflated were noted. POSTOPERATIVELY following parameters were noted: Coughing, sore throat, hoarseness were monitored 30 minutes after surgery in post anaesthesia care unit & 24 hours later. Pain was assessed using visual analogue scale. This study showed that: 1. Intracuff injection of alkalinized lignocaine reduces the cuff pressure during general anaesthesia with N2O compared to cuff inflated with air in which there is a gradual increase in cuff pressure. 2. Incidence of rise in systolic blood pressure during extubation was more in GROUP A compared to GROUP L. 3. ET tube tolerance during extubation was more with GROUP L compared to GROUP A. 4. Volume of lignocaine deflated during extubation was less than the infleated volume. But volume of air deflated was more than the inflated volume. 5. Incidence of sore throat was similar in immediate & less in late postoperative period in intra cuff lignocaine group (GROUP L) compared. CONCLUSION: From the data &statistical analysis, intracuff injection of alkalinized lignocaine instead of room air reduces the cuff pressure which provide better endotracheal tube tolerance with less hemodynamic changes during extubation and less incidence of sorethroat in post operative period.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cuff Pressure, Air and Alkalinized Lignocaine, General Anaesthesia, Comparative study.
Subjects: MEDICAL > Anaesthesiology
Depositing User: Subramani R
Date Deposited: 08 May 2018 19:44
Last Modified: 25 Mar 2020 16:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/7664

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