Comparison Between Lidocaine Inhalation and Intravenous Dexamethasone in Reducing Pain After Laryngeal Mask Insertion
Condition: Adult Patients Undergoing Elective Surgery With General Anesthesia and LMA Insertion
MeSH terms: Respiratory Aspiration
Study type: Interventional

Summary: 
      This study aimed to compare the efficacy between lidocaine inhalation vs intravenous
      dexamethasone to reduce pain after laryngeal mask insertion
    

Detailed description: 
      Approval from Ethical Committee of Faculty of Medicine Universitas Indonesia was acquired
      prior conducting the study. Subjects were given informed consent before enrolling the study
      and randomized into two groups (Lidocaine inhalation and Intravenous dexamethasone group).
      Intravenous (IV) cannula (18 or 20 G) , non-invasive blood pressure monitor, and
      pulse-oxymetry had been set on the subjects 10 minutes before anesthesia began. Vital signs
      were recorded. Lidocaine group received 1.5 mg/kg body weight (BW) of 2% lidocaine
      inhalation, diluted with 2-3 ml of normal saline until the total volume was 6 ml, and
      intravenous normal saline injection. Dexamethasone group received normal saline inhalation
      and 10 mg of intravenous dexamethasone. Subjects, authors, or inhalation giver were not aware
      of the content of any drug given. Coinduction was done using 0.05mg/kg BW of midazolam and
      2mcg/kg BW of fentanyl 5 minutes before the laryngeal mask airway (LMA) insertion. Induction
      was done using 2 mg/kg BW of 1% propofol and 0.5 mg/kg BW of atracurium 3 minutes before LMA
      insertion. Subjects were then given oxygenation using face mask without oropharyngeal airway.
      LMA was lubricated with normal saline. After 3 minutes of oxygenation, LMA was inserted using
      standard method. The LMA cuff was inflated with cuff pressure gauge of approximately 40 mmHg.
      After the position of LMA was confirmed to be correct, fixation was done using a tape.
      Maintenance of anesthesia was done using 50% oxygen in compressed air, 1% isoflurane, and
      atracurium. Thirty minutes before the surgery ended, 1 gram of paracetamol was given in 15
      minutes as post-surgery analgetic. After the surgery was ended, subjects were given 0.04
      mg/kg BW of neostigmine and 0.02 mg/kg BW of atropine. Mucus suction was performed on
      oropharynx and oral cavity gently, by using suction catheter 12F when subjects were still
      under anesthesia. After spontaneous breaths occured, LMA cuff was deflated and LMA was
      removed. Ventilation was continued using face mask without oropharyngeal airway. At the
      recovery room, pain on throat was assessed using Numerical Rating Scale. Assessment was done
      2 hours after surgery in the recovery room after subjects were fully alert with Aldrette
      score of 10. Throat pain was assessed during rest or swallowing. In addition, subjects were
      asked whether or not they experienced difficulty in swallowing or hoarseness.
    

Intervention name(s): lidocaine inhalation; intravenous dexamethasone
Intervention type(s): Drug
Intervention description(s): 1.5 mg/kg body weight (BW) of 2% lidocaine inhalation, diluted with 2-3 ml of normal saline until the total volume was 6 ml, and intravenous normal saline injection; Intravenous dexamethasone group: normal saline inhalation and 10 mg of intravenous dexamethasone.
Intervention MeSH terms: Dexamethasone; Lidocaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment