Proposed advantages | Reduction of postoperative cough, sore throat [53, 54], and dysphonia [55]. | Attenuate increases in heart rate and mean arterial pressure [13, 34, 35] and postoperative cough and sore throat [56]. | Reduction of postoperative cough [15, 44], nausea, and vomiting [45]. Increased respiratory rate [45]. Decreased agitation and need for rescue analgesic [45, 47]. | Attenuate increases in heart rate and mean arterial pressure [36]. Reduction of postoperative cough [36, 44]. | Attenuate increases in heart rate and mean arterial pressure [57, 58]. | Decreased postoperative sore throat [59, 60]. | Decreased postoperative sore throat and cough [61]. |
Proposed disadvantages | Unknown systemic absorption. | Cardiac arrhythmia local anesthetic toxicity (LAST). | Increased sedation, bradycardia, hypotension [15], time to emergence [47]. Expensive. | Increased postoperative nausea and vomiting. Added expense. | Hypotension. Heart block. Bradycardia. | Burning sensation and possible vomiting when applied [60]. | Limited evidence. Systemic steroid absorption. Steroid effects. |