# Efficacy of Lignocaine Jelly Versus Water-Based Lubricant in Preventing Postoperative Airway Morbidity After Endotracheal Intubation: A Prospective Comparative Study

## TL;DR

This study compares lignocaine jelly and water-based lubricant for reducing airway discomfort after intubation, finding the latter more effective and safer.

## Contribution

Demonstrates water-based lubricant is superior to lignocaine jelly in reducing postoperative airway symptoms after intubation.

## Key findings

- Water-based lubricant reduced sore throat, cough, and hoarseness more effectively than lignocaine jelly.
- Symptoms were significantly lower in the water-based group at early postoperative intervals.
- Both groups showed symptom resolution by 24 hours, but water-based jelly was safer and more cost-effective.

## Abstract

Background: Postoperative sore throat, cough, and hoarseness of voice are common sequelae of endotracheal intubation. These symptoms, although self-limiting, are distressing to patients and may affect their perioperative experience and satisfaction. Various methods have been explored to reduce these complications, including the lubrication of the endotracheal tube (ETT) with local anesthetics or simple lubricating agents. However, evidence regarding the comparative efficacy of lignocaine jelly and water-based lubricants remains inconclusive.

Aim: To compare the efficacy of lignocaine jelly and water-based lubricating jelly applied over ETTs in reducing postoperative sore throat, cough, and hoarseness of voice in patients undergoing elective surgery under general anesthesia.

Methods: This prospective, comparative study was conducted on 120 adult patients (American Society of Anesthesiologists (ASA) I-II, aged 18-60 years) posted for elective surgeries under general anesthesia with endotracheal intubation. Patients were randomly allocated into two groups: Group L (n=60), where 2% lignocaine jelly was applied to the ETT, and Group W (n=60), where water-based lubricating jelly was applied. Standardized anesthesia techniques were used in both groups. Postoperative assessment of sore throat, cough, and hoarseness of voice was carried out at 1, 6, 12, and 24 hours using a direct questionnaire and graded scoring system. Data were analyzed using SPSS (version 27) (IBM Corp., Armonk, NY), with chi-square and t-tests applied; p<0.05 was considered statistically significant.

Results: Both groups were comparable in demographic characteristics and intraoperative variables. The overall incidence and severity of postoperative sore throat, cough, and hoarseness were lower in the water-based jelly group compared to the lignocaine jelly group, with statistically significant differences noted particularly at early postoperative intervals. By 24 hours, most symptoms had subsided in both groups.

Conclusion: Water-based lubricating jelly applied over the ETT is more effective than lignocaine jelly in reducing the incidence and severity of postoperative sore throat, cough, and hoarseness of voice. Being inexpensive, widely available, and devoid of potential systemic side effects of lignocaine, it may be recommended as a safer alternative for routine clinical practice.