The comparative effect of lidocaine-remifentanil intravenous infusion and gargle on hemodynamic responses and sore throat and cough after endotracheal extubation: A randomized clinical trial

Purpose: The present evidence-based clinical study addressed the therapeutic effectiveness of lidocaine-remifentanil intravenous infusion versus gargle on attenuation of hemodynamic responses and prevention of sore throat and cough after endotracheal extubation. Materials and Methods: In a double-blind clinical trial whereby 76 cases receiving endotracheal intubation under general anesthesia were classified into two intervention groups being treated with lidocaine-remifentanil mixture administered by either intravenous infusion or gargle using balanced block randomization. Hemodynamic parameters including heart rate and blood pressure during surgery and in recovery every 15 min and respiratory symptoms such as cough, hoarseness, and sore throat during recovery and at certain postoperative time points of 2, 4, 8, 12, and 24 h were gathered. Pain score was measured by a Visual Analog Scale. Statistical analysis was conducted using the software SPSS v22 by Chi-square and independent t-test. Results: No statistically significant observed intergroup in terms of oxygen saturation, heart rate, mean blood pressure, need for analgesic medication, duration of surgery, and the incidence of cough and hoarseness (P > 0.05), but not in pain score in recovery and eight postoperative hours. While the intergroup difference was found at other times, the intravenous infusion group was associated with less pain score, compared to the gargling group (P > 0.05). Conclusion: A reduction in sore throat observed in subjects receiving an intravenous infusion compared to those receiving the gargling intervention during recovery and 8 h after surgery. We have convincing evidence to support the superiority of intravenous therapy comprising of lidocaine and remifentanil; however, larger sample size is needed to establish whether or not the interventions are effective.