Comparison of the use of uncuffed tracheal tube and cuff filled with saline, alkalinized lidocaine or air in pediatric patients

• Grant number: 10/18004-4
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2011
• End date: April 30, 2013
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Norma Sueli Pinheiro Módolo
• Grantee: Norma Sueli Pinheiro Módolo
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The use of tracheal tube in pediatric patients, especially in children that are under 8 years old, was for a long time performaded only with uncuffed tracheal tubes. The cuff was avoided because it may cause tracheal damage. Some studies showed the possibility of using a high compliance and low pressure tracheal tubes cuff in children without increasing the risk of airway injury. However, there are not studies comparing the use of cuffed tracheal tube filled with alkalinized lidocaine and its benefits. The use of lidocaine achieved good results in adults, because it prevented the rise of the cuff pressure during nitrous oxide anesthesia. Objective: Compare the effectiveness and safety of tracheal tube cuffs filled with air versus filled with alkalinized lidocaine versus filled with saline in children from 1 to 13 years old undergoing general anesthesia. Design: This will be a prospective clinical study. Methods: We will measure tracheal tubes cuff pressure in 150 pediatric patients that will be randomly allocated to four groups as follows: G1 (n = 50) patients intubated using cuff filled with saline ; G2 (n = 50) patients with cuff filled with alkalinized lidocaine ; G3 (n = 50) patients with cuff filled with air ; G4 (n = 50) patients with uncuffed tracheal tubes. In patients from G2 will be measure the blood level of lidocaine. During anesthesia half of each group with nitrous oxide and the other without. Gas or liquid will be removed as necessary to adjust cuff pressure to 20 cmH2O and the cuffs will be of high compliance and low pressure, lubricated with hydro-soluble gel before intubation. Discomfort after tracheal extubation, sore throat, hoarseness and coughing incidence will be studied at the time of discharge from the post-anesthesia care unit and 12 hours after anesthesia. (AU)