A comparative study on ultrasound guided superior laryngeal nerve block and lignocaine nebulization for hemodynamic stress response during suspension laryngoscopy in micro laryngeal surgeries - A prospective randomized double blinded study

Introduction

Microlaryngeal surgery (MLS) is the commonest endoscopic laryngeal procedure. Insertion of suspension laryngoscopy may lead to hemodynamic response such as rise in heart rate and blood pressure. This hemodynamic instability may cause myocardial ischemia, infarction, arrhythmia, rise of intraocular and intracranial pressure. This study was conducted to compare superior laryngeal nerve block and lignocaine nebulisation in microlaryngeal procedures to circumvent these complications.

Methodology

In this study 46 patients were enrolled in total, out of which 23 patients in Group A received 5 ml of 4 % lignocaine nebulization and Group B patients received superior laryngeal nerve block with 2 % lignocaine. The principal outcome evaluated was the hemodynamic stress response, specifically the alteration in heart rate. The secondary outcomes examined included systolic blood pressure (SBP), diastolic blood pressure (DBP), postoperative sore throat, cough, hoarseness of voice, as well as postoperative laryngospasm and desaturation

Results

In this study significantly lower heart rates were recorded in Group B when compared to that of Group A at 0, 3,5,9 min with a p value<0. 05. Similarly, significantly lower Systolic and diastolic blood pressures were observed in Group B patients when compared to that of Group A (p value<0 0.05). In this study, there is a significantly lower incidence of complications like sore throat and cough in Group B patients than that of Group A patients (P value < 0.01).

Conclusion

Ultrasound guided superior laryngeal nerve block was found to be more effective than lignocaine nebulization to prevent hemodynamic stress response and post operative complications following micro laryngeal surgery.