A comparative study between the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous lignocaine on coughing and hemodynamics during extubation in neurosurgical patients: a randomized controlled double-blind trial.

A prospective, randomized double-blind trial was performed to compare the effects of 4% endotracheal tube cuff lignocaine and 1.5 mg/kg intravenous (IV) lignocaine on coughing and hemodynamics during extubation in patients undergoing elective craniotomies in supine position. Forty-one patients received 4% lignocaine into the endotracheal tube cuff after intubation (ETT group) and 41 patients received IV lignocaine at 1.5 mg/kg before extubation (IV group). Coughing was assessed by a scale of 3 at the time of extubation. Hemodynamic parameters recorded at 1-minute interval after extubation for 5 minutes were compared with the baseline values recorded before skin closure. Results showed that there was no significant difference between the groups in terms of coughing or the hemodynamic response to tracheal extubation. In conclusion, 4% endotracheal tube cuff lignocaine was not superior to 1.5 mg/kg IV lignocaine in attenuating coughing and hemodynamic changes during extubation.