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Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study

BACKGROUND AND AIMS: Ultrasonography has emerged as a novel, portable, non-invasive tool encouraging airway assessment and procedural interventions. This study assesses the feasibility of ultrasound for block of internal branch of superior laryngeal nerve (ibSLN) block during upper airway anaesthesi...

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Autores principales: Ambi, Uday S, Arjun, BK, Masur, Shilpa, Endigeri, Archana, Hosalli, Vinod, Hulakund, SY
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474913/
https://www.ncbi.nlm.nih.gov/pubmed/28655950
http://dx.doi.org/10.4103/ija.IJA_74_17
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author Ambi, Uday S
Arjun, BK
Masur, Shilpa
Endigeri, Archana
Hosalli, Vinod
Hulakund, SY
author_facet Ambi, Uday S
Arjun, BK
Masur, Shilpa
Endigeri, Archana
Hosalli, Vinod
Hulakund, SY
author_sort Ambi, Uday S
collection PubMed
description BACKGROUND AND AIMS: Ultrasonography has emerged as a novel, portable, non-invasive tool encouraging airway assessment and procedural interventions. This study assesses the feasibility of ultrasound for block of internal branch of superior laryngeal nerve (ibSLN) block during upper airway anaesthesia to aid awake fibre-optic intubation. METHODS: Forty American Society of Anesthesiologists’ physical status I–II patients, aged 18–60 years, deemed to have a difficult airway (modified Mallampati class III–IV or inter-incisor distance <2.5 cm) and planned for awake fibre-optic intubation were randomised to either landmark group (L, n = 20) or ultrasound group (U, n = 20). All patients received nebulised 4% lignocaine (3 mL) and transtracheal injection 3 mL 2% lignocaine. Group L received landmark-guided bilateral ibSLN block with 1 mL 2% lignocaine. Group U received bilateral ibSLN block with 1 mL 2% lignocaine using a high-frequency ultrasound transducer to define the SLN space. The primary objective was assessment of quality of airway anaesthesia. Secondary objectives were time for intubation, haemodynamic parameters and patient perception of discomfort during procedure. RESULTS: The quality of anaesthesia was significantly better in Group U than in Group L (P < 0.001). The mean time for intubation was shorter in Group U (71.05 ± 9.57 s) compared to Group L (109.05 ± 30.09 s, P < 0.001). Heart rate, mean arterial pressure and patient perception of discomfort were significantly increased in Group L. CONCLUSION: Ultrasound for ibSLN block as a part of preparation for awake fibre-optic intubation improves quality of airway anaesthesia and patient tolerance.
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spelling pubmed-54749132017-06-27 Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study Ambi, Uday S Arjun, BK Masur, Shilpa Endigeri, Archana Hosalli, Vinod Hulakund, SY Indian J Anaesth Original Article BACKGROUND AND AIMS: Ultrasonography has emerged as a novel, portable, non-invasive tool encouraging airway assessment and procedural interventions. This study assesses the feasibility of ultrasound for block of internal branch of superior laryngeal nerve (ibSLN) block during upper airway anaesthesia to aid awake fibre-optic intubation. METHODS: Forty American Society of Anesthesiologists’ physical status I–II patients, aged 18–60 years, deemed to have a difficult airway (modified Mallampati class III–IV or inter-incisor distance <2.5 cm) and planned for awake fibre-optic intubation were randomised to either landmark group (L, n = 20) or ultrasound group (U, n = 20). All patients received nebulised 4% lignocaine (3 mL) and transtracheal injection 3 mL 2% lignocaine. Group L received landmark-guided bilateral ibSLN block with 1 mL 2% lignocaine. Group U received bilateral ibSLN block with 1 mL 2% lignocaine using a high-frequency ultrasound transducer to define the SLN space. The primary objective was assessment of quality of airway anaesthesia. Secondary objectives were time for intubation, haemodynamic parameters and patient perception of discomfort during procedure. RESULTS: The quality of anaesthesia was significantly better in Group U than in Group L (P < 0.001). The mean time for intubation was shorter in Group U (71.05 ± 9.57 s) compared to Group L (109.05 ± 30.09 s, P < 0.001). Heart rate, mean arterial pressure and patient perception of discomfort were significantly increased in Group L. CONCLUSION: Ultrasound for ibSLN block as a part of preparation for awake fibre-optic intubation improves quality of airway anaesthesia and patient tolerance. Medknow Publications & Media Pvt Ltd 2017-06 /pmc/articles/PMC5474913/ /pubmed/28655950 http://dx.doi.org/10.4103/ija.IJA_74_17 Text en Copyright: © 2017 Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Ambi, Uday S
Arjun, BK
Masur, Shilpa
Endigeri, Archana
Hosalli, Vinod
Hulakund, SY
Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study
title Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study
title_full Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study
title_fullStr Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study
title_full_unstemmed Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study
title_short Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study
title_sort comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: a prospective randomised clinical study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474913/
https://www.ncbi.nlm.nih.gov/pubmed/28655950
http://dx.doi.org/10.4103/ija.IJA_74_17
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