ENDOTRACHEAL Tube LIDOCAINE

Emergence coughing or bucking is a common complication of general anesthesia withendotracheal intubation and may result in clinically significant increases in hemodynamicstress, airway irritation, postoperative discomfort, and potential complications.Although multiple pharmacologic strategies have been evaluated to reduce emergencecoughing, the effectiveness of topical lidocaine preparations applied to the endotrachealtube remains uncertain.This prospective, randomized, double‐blind, two‐arm clinical trial will evaluate whetherapplying 5% lidocaine ointment to the external surface of the endotracheal tube beforeintubation reduces coughing or bucking during emergence from general anesthesia comparedwith standard water‐based endotracheal tube lubricant.Adult patients undergoing elective surgical procedures requiring general anesthesia withoral endotracheal intubation will be randomized to receive either 5% lidocaine ointmentor standard water‐based lubricant applied to the external surface of the endotrachealtube immediately prior to intubation. The study will use standardized anestheticmanagement, double‐blinding procedures, and consistent outcome assessment methods.The primary outcome is the incidence of coughing or bucking during emergence fromanesthesia, assessed from the time anesthetic agents are reduced for extubation untilremoval of the endotracheal tube. Secondary outcomes include the incidence and severityof postoperative sore throat and hoarseness at defined postoperative time points, as wellas total intraoperative opioid administration converted to morphine milligramequivalents.Additional demographic and procedural information, including age, sex, body mass index,American Society of Anesthesiologists physical status, airway assessment characteristics,duration of intubation, and surgical procedure type, will be collected to describe thestudy population and evaluate potential factors associated with outcomes.The study aims to determine whether 5% lidocaine ointment provides a clinically usefulstrategy for reducing emergence‐related airway irritation and improving postoperativeairway comfort compared with standard endotracheal tube lubrication.