Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation
Abstract Background Endotracheal intubation may be performed using deep anesthesia, neuromuscular blocks, or the topical application of anesthetics on the vocal cords. The null hypothesis in this study was that there is no difference in hoarseness one hour after extubation between patients receiving...
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BMC
2025-06-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02798-8 |
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| author | Tobias Fjærestad Petter Øyrås Knut Inge Solbakk Ann-Chatrin Linqvist Leonardsen |
| author_facet | Tobias Fjærestad Petter Øyrås Knut Inge Solbakk Ann-Chatrin Linqvist Leonardsen |
| author_sort | Tobias Fjærestad |
| collection | DOAJ |
| description | Abstract Background Endotracheal intubation may be performed using deep anesthesia, neuromuscular blocks, or the topical application of anesthetics on the vocal cords. The null hypothesis in this study was that there is no difference in hoarseness one hour after extubation between patients receiving neuromuscular blocks versus lidocaine sprayed on the glottis for endotracheal intubation. Methods A randomized, controlled, double-blinded study was conducted. A total of 114 patients were included. Group I (n = 58) received rocuronium 0.6 mg/kg. Group II (n = 56) received lidocaine spray 4 ml (20 mg/ml) on the vocal cords. The primary outcome measure was hoarseness one hour after extubation. Secondary outcomes were hoarseness at 24 and 48 h after extubation, sore throat at 1, 24, and 48 h after extubation, and intubation and extubation conditions. Results There was no statistically significant difference between groups in hoarseness one hour after extubation. At 24 h, Group I had significantly more reported hoarseness (27.6%) and observed hoarseness (1.7%) than Group II (12.5% reported) (p = 0.03). Group II had a significantly sorer throat (21.4%) than Group I (1.7%) (p < 0.001) at one hour. Beyond this, there were no differences between groups. Conclusion Even though some differences were observed in hoarseness and sore throat 24 h after extubation, there were few differences between topical lidocaine spray and the use of neuromuscular blocks before intubation for patient-reported and observed outcomes. Consequently, clinicians should choose an approach based on considerations other than those included in this study, such as the need for muscle relaxation or minimizing the number of laryngoscopies. The study was prospectively registered at Clinicaltrials.gov NCT05614609 |
| format | Article |
| id | doaj-art-e7bf0f58aa70416584d37f3629b714ee |
| institution | OA Journals |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-e7bf0f58aa70416584d37f3629b714ee2025-08-20T02:10:35ZengBMCEuropean Journal of Medical Research2047-783X2025-06-013011710.1186/s40001-025-02798-8Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubationTobias Fjærestad0Petter Øyrås1Knut Inge Solbakk2Ann-Chatrin Linqvist Leonardsen3Department of Anaesthesia, Ostfold Hospital TrustDepartment of Anaesthesia, Ostfold Hospital TrustDepartment of Anaesthesia, Ostfold Hospital TrustFaculty of Health, Welfare and Organisation, Ostfold University CollegeAbstract Background Endotracheal intubation may be performed using deep anesthesia, neuromuscular blocks, or the topical application of anesthetics on the vocal cords. The null hypothesis in this study was that there is no difference in hoarseness one hour after extubation between patients receiving neuromuscular blocks versus lidocaine sprayed on the glottis for endotracheal intubation. Methods A randomized, controlled, double-blinded study was conducted. A total of 114 patients were included. Group I (n = 58) received rocuronium 0.6 mg/kg. Group II (n = 56) received lidocaine spray 4 ml (20 mg/ml) on the vocal cords. The primary outcome measure was hoarseness one hour after extubation. Secondary outcomes were hoarseness at 24 and 48 h after extubation, sore throat at 1, 24, and 48 h after extubation, and intubation and extubation conditions. Results There was no statistically significant difference between groups in hoarseness one hour after extubation. At 24 h, Group I had significantly more reported hoarseness (27.6%) and observed hoarseness (1.7%) than Group II (12.5% reported) (p = 0.03). Group II had a significantly sorer throat (21.4%) than Group I (1.7%) (p < 0.001) at one hour. Beyond this, there were no differences between groups. Conclusion Even though some differences were observed in hoarseness and sore throat 24 h after extubation, there were few differences between topical lidocaine spray and the use of neuromuscular blocks before intubation for patient-reported and observed outcomes. Consequently, clinicians should choose an approach based on considerations other than those included in this study, such as the need for muscle relaxation or minimizing the number of laryngoscopies. The study was prospectively registered at Clinicaltrials.gov NCT05614609https://doi.org/10.1186/s40001-025-02798-8IntubationLidocaine sprayNeuromuscular blocksRandomized controlled tria |
| spellingShingle | Tobias Fjærestad Petter Øyrås Knut Inge Solbakk Ann-Chatrin Linqvist Leonardsen Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation European Journal of Medical Research Intubation Lidocaine spray Neuromuscular blocks Randomized controlled tria |
| title | Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation |
| title_full | Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation |
| title_fullStr | Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation |
| title_full_unstemmed | Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation |
| title_short | Upper airway discomfort: a randomized controlled double-blind trial comparing rocuronium and lidocaine spray for intubation |
| title_sort | upper airway discomfort a randomized controlled double blind trial comparing rocuronium and lidocaine spray for intubation |
| topic | Intubation Lidocaine spray Neuromuscular blocks Randomized controlled tria |
| url | https://doi.org/10.1186/s40001-025-02798-8 |
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