An experimental study on topical application of 2% lignocaine jelly for preventing coughing and sore throat post extubation in elective surgeries in smokers vs. non-smokers

Abstract

Incidence of cough and sore throat post-extubation is known to be increased in cigarette smokers. Simple methods with minimal side-effects like application of 2% lignocaine jelly is observed to reduce such complications in the normal population. The rationale of this study is to directly compare such effects between smokers and non-smokers.It is an observational study including 60 participants aged between 20 to 60 years with ASA 1 and 2 physical status undergoing elective surgery under general anaesthesia. The patients were randomized in to two groups - smokers and non-smokers. Lignocaine 2% jelly was applied to endo-tracheal tube cuffs in both groups. Comparison was made between the two groups with regards to post operative cough and sore throat at intervals of 1 hour and 24 hours post extubation as well as hemodynamic variability at pre-induction, 3 mins, 15 mins post intubation and 3 mins post extubation. Students t-test, Fishers exact test and Mann-Whitney test was used for comparison between the two groups.1-hour sore throat was significantly lower in non-smoker group (p=0.000). However, incidence of 24-hour sore throat was comparable (p=0.104). The number and severity of cough was greater in smoker group, even after the application of 2% lignocaine jelly (p=0.003). There was no significant difference in hemodynamic variables pre and postoperatively.Noticeable difference was observed between smokers and non-smokers with regard to respiratory complications post-extubation. We must consider smoking as a public health hazard and effects of chronic smoking cannot be discounted when taking in to account benefits observed with lignocaine jelly on ET tube cuffs.