Fang P, et al. - Given that the airway reflex (eg, cough) is most commonly accompanied by severe fluctuations of hemodynamics during emergence, researchers conducted this prospective, double-blind, randomized trial to investigate whether topical ropivacaine may attenuate extubation response and postoperative sore throat. Participants included 54 patients undergoing thyroidectomy who were randomized to either 0.75% ropivacaine, which was sprayed on the tracheal mucosa, epiglottis, tongue base, and glottis to achieve uniform surface anesthesia (Group R) or an equivalent measure of volume saline (Group C; control group). The primary outcome was the incidence and grade of cough during peri-extubation. They found the incidence of cough during extubation to be lower in Group R vs Group C, and sore throat visual acuity score at 12 hours post-surgery was also lower in Group R than in Group C. Findings indicated that topical anesthesia with 0.75% ropivacaine prior to intubation can significantly reduce the incidence of cough during peri-extubation; it can also reduce hemodynamic fluctuations and postoperative throat pain without affecting patients' recovery.