Comparison between lignocaine nebulization and airway nerve block for awake fiberoptic bronchoscopy-guided nasotracheal intubation: a single-blind randomized prospective study.
10.4097/kjae.2018.71.2.120
- Author:
Pooja Rawat MATHUR
1
;
Neena JAIN
;
Aji KUMAR
;
Beena THADA
;
Veena MATHUR
;
Deepak GARG
Author Information
1. Department of Anesthesia, Jawaharlal Nehru Medical College, Ajmer, India. drpoojarawat@gmail.com
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Airway management;
Dexmedetomidine;
Intubation;
Lignocaine;
Nebulizers;
Nerve block
- MeSH:
Adult;
Airway Management;
Anesthesia;
Anesthesia, General;
Cough;
Dexmedetomidine;
Humans;
Intubation*;
Lidocaine*;
Nebulizers and Vaporizers;
Nerve Block*;
Patient Satisfaction;
Prospective Studies*;
Recurrent Laryngeal Nerve;
Vocal Cords
- From:Korean Journal of Anesthesiology
2018;71(2):120-126
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The preferred management strategy for difficult airways is awake fiberoptic bronchoscopy-guided intubation, which requires effective airway anesthesia to ensure patient comfort and acceptance. This randomized single-blind prospective study was conducted to compare lignocaine nebulization and airway nerve block for airway anesthesia prior to awake fiberoptic bronchoscopy-guided intubation. METHODS: Sixty adult patients scheduled for surgical procedures under general anesthesia were randomly allocated to two groups. Group N received jet nebulization (10 ml of 4% lignocaine) and Group B received bilateral superior laryngeal and transtracheal recurrent laryngeal nerve blocks (each with 2 ml of 2% lignocaine) followed by fiberoptic bronchoscopy-guided nasotracheal intubation. All patients received procedural sedation with dexmedetomidine. The intubation time, intubating conditions, vocal cord position, cough severity, and degree of patient satisfaction were recorded. Student’s t test was used to analyze parametric data, while the Mann-Whitney U test was applied to non-parametric data and Fisher’s test to categorical data. P values < 0.05 were considered statistically significant. RESULTS: The time taken for intubation was significantly shorter in Group B [115.2 (14.7) s compared with Group N [214.0 (22.2) s] (P = 0.029). The intubating conditions and degree of patient comfort were better in Group B compared with Group N. Although all patients were successfully intubated, patient satisfaction was higher in Group B. CONCLUSIONS: Airway nerve blocks are preferable to lignocaine nebulization as they provide superior-quality airway anesthesia. However, nebulization may be a suitable alternative when a nerve block is not feasible.
