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Intravenous LIGNOcaine for the POstoperative Sore Throat (LIGNO-POST)

9. november 2026 opdateret af: Ka Ting Ng, University of Malaya

Intravenous LIGNOcaine for the POstoperative Sore Throat: A Double-blinded Randomised Placebo-controlled Trial (LIGNO-POST Trial)

Patients often encounter unpleasant sore throat after surgery when wake up from general anaesthesia and pulling off breathing tube. Lignocaine is a medication used in anaesthesia for the properties of analgesia and anti-inflammation. Other studies suggested that lignocaine spray/ gel can reduce the postoperative sore throat after extubation in patients undergoing surgery. However, it can reduce the gag reflex, resulting in higher risk of aspiration after surgery. Therefore, this randomized, double-blind, placebo-controlled trial is designed to determine whether giving intravenous lignocaine toward the end of the surgery before extubation can reduce postoperative sore throat and discomfort after surgery. It is hypothesized that intravenous lignocaine can reduce postoperative sore throat in patients undergoing general anaesthesia.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Postoperative sore throat (POST) is a common and discomfort adverse event following general anaesthesia with orotracheal intubation, with reported incidences ranging from 30% to 70%. It is characterized by pain or discomfort at the larynx or pharynx during postoperative period in the recovery area, which can affect the overall perioperative experience and patient satisfaction. The pathophysiology of POST is believed due to mechanical trauma to the pharyngeal and laryngeal mucosa during intubation, cuff-related pressure injury, and airway inflammation that cause postoperative throat symptoms. Several non-pharmacological and pharmacological measures such as lozenges, gargles, lignocaine spray and steroid injection have been experimented with mixed findings.

Lignocaine is a local anaesthetic agent, which has the properties of analgesia and anti-inflammatory effect via the blockade of sodium channel receptor. Lignocaine spray at the throat is believed to reduce the severity of POST at various concentration (2%, 5% and 10%). However, studies reported that some of the additives agents (methanol, ethanol) in the lignocaine spray have irritating side effects to damage tracheal mucosa, negating the effect of topical lignocaine on the incidence of POST. In addition, topicalized lignocaine reduces the gag reflex if given too late before extubation, resulting in higher risk of aspiration in the recovery area.

In a routine general anaesthesia, intravenous dexamethasone is administered as an analgesic adjunct and anti-inflammatory to minimize airway edema. Administering intravenous lignocaine prior to extubation is believed to provide analgesic effect to reduce incidence of POST and postoperative cough after general anaesthesia. However, the evidence regarding its effect on POST remains limited and inconsistent, particularly when administered near the time of emergence from general anaesthesia.

Therefore, this randomized, double-blind, placebo-controlled trial is aimed to examine the use of intravenous lignocaine prior to extubation in the reduction of POST in surgical patients undergoing oral intubation during general anaesthesia in University Malaya Medical Centre.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

398

Fase

  • Fase 4

Kontakter og lokationer

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Studiekontakt

Studiesteder

  • Malaysia
    • Kuala Lumpur
      • Kuala Lumpur, Kuala Lumpur, Malaysia, 59100
        • Universiti Malaya Medical Centre

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Adults aged 18-65 years.
  • American Society of Anaesthesiologists (ASA 1-2).
  • Scheduled for elective non-airway surgery requiring general anaesthesia with orotracheal intubation of anticipated duration ≥ 90 minutes.
  • Able to understand the patient information sheet (in English or Bahasa Malaysia) and provide written informed consent.

Exclusion Criteria:

  • ASA physical status III-V.
  • Body mass index < 18 or > 40 kg/m².
  • Known hypersensitivity to amide local anaesthetics, including lignocaine.
  • Anticipated difficult airway (Mallampati III-IV, mouth opening < 3 cm, restricted neck extension, thyromental distance < 6 cm).
  • Upper respiratory tract infection within the preceding 2 weeks; chronic cough; pre-existing sore throat or hoarseness.
  • Airway, head-and-neck, dental, or thoracic surgery; surgery requiring transoesophageal echocardiography.
  • History of significant cardiac arrhythmia, second- or third-degree heart block, or hepatic impairment (Child-Pugh B or C).
  • Pregnancy or lactation.
  • Inability to perform self-report outcome assessment owing to cognitive impairment or language barrier.
  • Concurrent systemic lignocaine or anti-arrhythmic class I therapy.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Group L (lignocaine)
Medicin: Intravenous lignocaine

IV lignocaine 1.5 mg/kg, calculated on lean body weight (LBW).
Placebo komparator: Group P (placebo)
Medicin: Normal Saline (0.9% NaCl)

0.9% normal saline

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of postoperative sore throat (POST)
Tidsramme: 1-hour, 6-hour, 24-hour after surgery

Patient-reported pain/discomfort in throat (yes/no) on standardised question.
1-hour, 6-hour, 24-hour after surgery

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Severity of POST
Tidsramme: 1-hour, 6-hour, 24-hour after surgery

NRS 0-10 (0 = none, 10 = worst imaginable).
1-hour, 6-hour, 24-hour after surgery
Incidence and severity of postoperative cough
Tidsramme: 1-hour, 6-hour, 24-hour after surgery

Observation of cough in post anaesthesia care unit (yes/no); 4-point scale: 0 none, 1 mild (single), 2 moderate (> 1 episode), 3 severe (constant).
1-hour, 6-hour, 24-hour after surgery
Incidence of post-extubation hoarseness
Tidsramme: 1-hour, 6-hour, 24-hour after surgery

Stout's 4-point grading: 0 no hoarseness, 1 mild hoarseness (only noticed by patient), 2 severe hoarseness (noticed by medical personnel), 3 aphonia (total inability to speak)
1-hour, 6-hour, 24-hour after surgery
Patient satisfaction
Tidsramme: 24-hour after surgery

NRS 0-10 (0 = not satisfy, 10 = very satisfy)
24-hour after surgery
Adverse events of intravenous lignocaine
Tidsramme: During surgery and 1-hour after surgery in post anaesthesia care unit

haemodynamic events (HR < 50 or > 100, MAP < 65 or > 110); seizure, perioral numbness, dizziness, tinnitus.
During surgery and 1-hour after surgery in post anaesthesia care unit

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Malaya

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. januar 2027

Primær færdiggørelse (Anslået)

31. december 2027

Studieafslutning (Anslået)

31. december 2027

Datoer for studieregistrering

Først indsendt

4. november 2026

Først indsendt, der opfyldte QC-kriterier

9. november 2026

Først opslået (Faktiske)

13. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • V1.1

Plan for individuelle deltagerdata (IPD)

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INGEN

IPD-planbeskrivelse

Requests for de-identified data from qualified researchers may be considered by the principal investigator on a case-by-case basis, subject to approval by the ethics committee.

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