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Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study

BACKGROUND AND AIMS: Awake fibreoptic intubation (AFOI) is the gold standard in the management of the difficult airway. Several methods to achieve airway anesthesia to aid AFOI include superior laryngeal nerve block (SLNB). This study aimed to compare land-mark-guided and ultrasound-guided technique...

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Autores principales: Magadum, Nandini Basappa, Nileshwar, Anitha, Vijayakumara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410032/
https://www.ncbi.nlm.nih.gov/pubmed/37564844
http://dx.doi.org/10.4103/joacp.joacp_270_21
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author Magadum, Nandini Basappa
Nileshwar, Anitha
Vijayakumara
author_facet Magadum, Nandini Basappa
Nileshwar, Anitha
Vijayakumara
author_sort Magadum, Nandini Basappa
collection PubMed
description BACKGROUND AND AIMS: Awake fibreoptic intubation (AFOI) is the gold standard in the management of the difficult airway. Several methods to achieve airway anesthesia to aid AFOI include superior laryngeal nerve block (SLNB). This study aimed to compare land-mark-guided and ultrasound-guided techniques for SLNB to aid AFOI. MATERIAL AND METHODS: This was a prospective, observational study. Patients in both groups received 1 mg Midazolam and 50 μg of fentanyl for mild sedation before intubation, nasal passages were anaesthetized using lignocaine-coated nasopharyngeal airways, nebulization of 3 ml of 2% lignocaine, and intratracheal injection of 2 ml of 2% lignocaine given through cricothyroid membrane. Patients in Group L received SNLB, at the lateral end of the thyrohyoid membrane (2 ml of 1.5% lignocaine). Patients in Group U had their thyrohyoid membrane visualized using linear ultrasound probe (8 – 13 Hz) and the injection was placed just superficial to the membrane using out of plane method. The groups were compared with respect to quality of anesthesia (assessed on a 5-point scale), patient comfort during AFOI, time taken to intubation and Haemodynamics. RESULTS: A total of 25 patients were enrolled: 13 in Group L and 12 patients in Group U. The demographics were comparable. Quality of airway anesthesia, time taken to intubation, haemodynamics and patient comfort were comparable. All were intubated successfully and there were no complications. CONCLUSION: USG-guided SLNB was comparable to landmark-based method with respect to quality of airway anesthesia and patient comfort. USG-guided block did not add any advantage over the landmark-based method.
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spelling pubmed-104100322023-08-10 Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study Magadum, Nandini Basappa Nileshwar, Anitha Vijayakumara J Anaesthesiol Clin Pharmacol Original Article BACKGROUND AND AIMS: Awake fibreoptic intubation (AFOI) is the gold standard in the management of the difficult airway. Several methods to achieve airway anesthesia to aid AFOI include superior laryngeal nerve block (SLNB). This study aimed to compare land-mark-guided and ultrasound-guided techniques for SLNB to aid AFOI. MATERIAL AND METHODS: This was a prospective, observational study. Patients in both groups received 1 mg Midazolam and 50 μg of fentanyl for mild sedation before intubation, nasal passages were anaesthetized using lignocaine-coated nasopharyngeal airways, nebulization of 3 ml of 2% lignocaine, and intratracheal injection of 2 ml of 2% lignocaine given through cricothyroid membrane. Patients in Group L received SNLB, at the lateral end of the thyrohyoid membrane (2 ml of 1.5% lignocaine). Patients in Group U had their thyrohyoid membrane visualized using linear ultrasound probe (8 – 13 Hz) and the injection was placed just superficial to the membrane using out of plane method. The groups were compared with respect to quality of anesthesia (assessed on a 5-point scale), patient comfort during AFOI, time taken to intubation and Haemodynamics. RESULTS: A total of 25 patients were enrolled: 13 in Group L and 12 patients in Group U. The demographics were comparable. Quality of airway anesthesia, time taken to intubation, haemodynamics and patient comfort were comparable. All were intubated successfully and there were no complications. CONCLUSION: USG-guided SLNB was comparable to landmark-based method with respect to quality of airway anesthesia and patient comfort. USG-guided block did not add any advantage over the landmark-based method. Wolters Kluwer - Medknow 2023 2022-01-12 /pmc/articles/PMC10410032/ /pubmed/37564844 http://dx.doi.org/10.4103/joacp.joacp_270_21 Text en Copyright: © 2022 Journal of Anaesthesiology Clinical Pharmacology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Magadum, Nandini Basappa
Nileshwar, Anitha
Vijayakumara
Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study
title Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study
title_full Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study
title_fullStr Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study
title_full_unstemmed Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study
title_short Comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - An observational study
title_sort comparison of landmark-guided and ultrasound-guided technique for superior laryngeal nerve block to aid fibreoptic intubation - an observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410032/
https://www.ncbi.nlm.nih.gov/pubmed/37564844
http://dx.doi.org/10.4103/joacp.joacp_270_21
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