{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:27:45Z","timestamp":1786649265927,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"\n Background and Aims:<\/jats:title>\n Cough is frequently encountered during extubation. We propose a novel technique of utilising the suction port of a subglottic suction drainage endotracheal tube (SSD-ETT) to instil lignocaine around the cuff and improve tube tolerance during extubation. The primary objective was to assess the cough score during emergence. Secondary objectives included changes in haemodynamics and postoperative oropharyngeal morbidities.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n In total, 108 patients undergoing nasal surgery were tracheally intubated with the SSD-ETT and randomised to receive normal saline (NS) both intravenous and subglottic (Group C), subglottic NS and intravenous lignocaine (Group IVL), and subglottic lignocaine and intravenous NS (Group SGL) before reversal of residual neuromuscular blockade. The volume for subglottic administration was fixed at 3 mL of either 2% lignocaine or NS. The volume for intravenous administration was 1.5 mg\/kg of 2% lignocaine or an equivalent volume of NS. Tube tolerance was graded using a 5-point qualitative cough score. Haemodynamics were recorded at baseline, post-intubation, and post-extubation. Postoperative oropharyngeal morbidities were also compared.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Seventy-five percent of patients in Group SGL had no cough, compared to 27.8% in Group IVL and 30% in Group C (\n P<\/jats:italic>\n < 0.001). The heart rate immediately following extubation was significantly lower (\n P<\/jats:italic>\n = 0.006) in Group SGL: 96 [standard deviation (SD): 19)] [95% confidence interval (CI): 90, 103] beats\/min when compared with Group C: 107 (SD: 15) (95% CI: 102, 112) and Group IVL: 108 (SD: 18) (95% CI: 102, 114). The mean arterial pressure and oropharyngeal morbiditiy were comparable (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Subglottic instillation of lignocaine significantly improves tube tolerance during extubation and has favourable effects on heart rate compared to intravenous administration.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_175_25","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T10:00:20Z","timestamp":1752141620000},"page":"794-800","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Lignocaine instilled through the suction channel of a subglottic suction drainage tracheal tube improves tube tolerance during extubation compared to intravenous lignocaine: A double-blinded randomised controlled trial"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1164-3610","authenticated-orcid":false,"given":"R","family":"Sripriya","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, AIIMS Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8890-1793","authenticated-orcid":false,"given":"Jyotsna","family":"Namburu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, AIIMS Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7854-7001","authenticated-orcid":false,"given":"Ghansham","family":"Biyani","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, AIIMS Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-1124","authenticated-orcid":false,"given":"Nageswara Rao","family":"Tangirala","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, AIIMS Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0373-4547","authenticated-orcid":false,"given":"Vaishakh","family":"Tharavath","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, AIIMS Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3178-1095","authenticated-orcid":false,"given":"Raza S.","family":"Gouri","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, AIIMS Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"R1-20260421","first-page":"1","article-title":"Evaluation of hemodynamic response between laryngeal mask airway and endotracheal tube extubation with general anaesthesia","volume":"8","author":"Balasubramanian","year":"2017","journal-title":"J Anesth Clin Res"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1213\/ane.0b013e31819b03d8","article-title":"The effect of low-dose remifentanil on responses to the endotracheal tube during emergence from general anaesthesia","volume":"108","author":"Aouad","year":"2009","journal-title":"Anesth Analg"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"162","DOI":"10.4103\/0970-9185.111665","article-title":"A double blind, randomized, controlled trial to study the effect of dexmedetomidine on hemodynamic and recovery responses during tracheal extubation","volume":"29","author":"Bindu","year":"2013","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"486","DOI":"10.4103\/ija.ija_1013_23","article-title":"Efficacy of endotracheal tube cuff lignocaine in the prevention of postextubation cough in children undergoing elective surgeries-A randomised controlled trial","volume":"68","author":"Kavyashree","year":"2024","journal-title":"Indian J Anaesth"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"342","DOI":"10.4103\/0019-5049.158733","article-title":"Effect of peri-operative intravenous infusion of lignocaine on haemodynamic responses to intubation, extubation and post-operative analgesia","volume":"59","author":"Jain","year":"2015","journal-title":"Indian J Anaesth"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1213\/01.ANE.0000132779.27085.52","article-title":"Laryngotracheal topicalization with lidocaine before 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extubation following general anesthesia","volume":"9","author":"Gladston","year":"2022","journal-title":"North Clin Istanb"},{"key":"R10-20260421","first-page":"205","article-title":"Prophylactic versus therapeutic administration of intravenous lidocaine for suppression of post-extubation cough following cataract surgery: A randomized double-blind placebo controlled clinical trial","volume":"43","author":"Saghaei","year":"2005","journal-title":"Acta Anaesthesiol Taiwan"},{"key":"R11-20260421","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/BF03020540","article-title":"On smooth extubation without coughing and bucking","volume":"49","author":"Chan","year":"2002","journal-title":"J Can Anesth"},{"key":"R12-20260421","first-page":"29","article-title":"Lidocaine reduces endotracheal tube associated side effects when instilled over the glottis but not when used to inflate the cuff: A double blind, placebo-controlled, randomized trial","volume":"92","author":"Bousselmi","year":"2014","journal-title":"Tunis Med"},{"key":"R13-20260421","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/s12630-013-9896-8","article-title":"The effects of lidocaine spray and intracuff alkalinized lidocaine on the occurrence of cough at extubation: A double-blind randomized controlled trial","volume":"60","author":"D\u2019Aragon","year":"2013","journal-title":"Can J Anaesth"},{"key":"R14-20260421","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/j.1399-6576.1992.tb03554.x","article-title":"Onset and duration of hypoalgesia of lidocaine spray applied to oral mucosa--A dose response study","volume":"36","author":"Sch\u00f8nemann","year":"1992","journal-title":"Acta Anaesthesiol Scand"}],"container-title":["Indian Journal of 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History"}},{"value":"2025-06-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}