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

9 november 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

398

Fas

  • Fas 4

Kontakter och platser

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Studiekontakt

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 65 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Group L (lignocaine)
Läkemedel: Intravenous lignocaine

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

0.9% normal saline

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Incidence of postoperative sore throat (POST)
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Severity of POST
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 24-hour after surgery

NRS 0-10 (0 = not satisfy, 10 = very satisfy)
24-hour after surgery
Adverse events of intravenous lignocaine
Tidsram: 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

Samarbetspartners och utredare

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Sponsor

University of Malaya

Publikationer och användbara länkar

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Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 januari 2027

Primärt slutförande (Beräknad)

31 december 2027

Avslutad studie (Beräknad)

31 december 2027

Studieregistreringsdatum

Först inskickad

4 november 2026

Först inskickad som uppfyllde QC-kriterierna

9 november 2026

Första postat (Faktisk)

13 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

13 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

9 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • V1.1

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IPD-planbeskrivning

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