Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques

Sethi, Nitin; Tarneja, VK; Madhusudanan, TP; Shouche, Sachin

doi:10.1016/s0377-1237(05)80112-1

Cited by 15 publications

(25 citation statements)

References 15 publications

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“…In our study, the intubating conditions were better in Group B compared with Group N, similar to the studies of Webb et al [ 9 ], Graham et al [ 10 ], and Sethi et al [ 15 ]. However, Reasoner et al [ 14 ] and Gupta et al [ 6 ] found no significant difference in intubating conditions between groups.…”

Section: Discussionsupporting

confidence: 91%

Comparison between lignocaine nebulization and airway nerve block for awake fiberoptic bronchoscopy-guided nasotracheal intubation: a single-blind randomized prospective study

Mathur

Jain

Kumar

et al. 2018

Korean J Anesthesiol

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BackgroundThe 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.MethodsSixty 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.ResultsThe 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.ConclusionsAirway 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.

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Section: Discussionsupporting

confidence: 91%

Comparison between lignocaine nebulization and airway nerve block for awake fiberoptic bronchoscopy-guided nasotracheal intubation: a single-blind randomized prospective study

Mathur

Jain

Kumar

et al. 2018

Korean J Anesthesiol

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“…Adequate airway topical with minimum dosage of lignocaine is of supreme importance for patient safety .A reasonable waiting period after every spray is preferred. [27] The quality of anaesthesia was significantly better in Group A as evidenced by significantly higher patients showed procedure was not unpleasant (Grade 1 Severity score).Similar to our study Lt Col Sethi et al, [24] found that quality of laryngeal anaesthesia was significantly better in spray-as-yougo method as evidenced by lower severity scale (P<0.05) where grading of overall intubation condition was better for spray-as-you-go group (P<0.01).However Graham et al, [25] Sharma et al, [26] reported better patient comfort by transtracheal injection of local anaesthetic than spray-as-you-go method. In our study, reaction score was significantly better in group A than Group C and Group B.…”

Section: Discussionsupporting

confidence: 88%

“…Reasoner et al, [23] found no significant difference in intubation time between nerve block and topical anesthesia groups. The total dose of lignocaine including extra dose was lesser in Group A(404mg) than Group C(418mg) and Group B(436mg).However Lt Col Sethi et al, [24] found lesser amount of extra dose of lignocaine in spray-as-you-go technique but was more than transcricoid injection technique and less than nebulisation. Most authors recommend higher safe dose of topical lignocaine viz 8-9mg/kg, except in elderly or those with hepatic or cardiac impairement.…”

Section: Discussionmentioning

confidence: 89%

Awake Fiberoptic Intubation: Comparison Of Three Techniques of Spray-As-You-Go

Shobha¹,

Bhatia²,

Chamoli³

et al. 2018

AIMDR

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“…Hal ini sesuai dengan hipotesis penelitian ini yaitu kualitas intubasi yang difasilitasi oleh blok nervus superior laringeus dan transtrakeal setara dengan yang difasilitasi oleh obat pelumpuh otot yang juga sejalan dengan penelitian sebelumnya. 9,16 Penelitian ini menemukan perbedaan yang sangat signifikan (p=<0.001) pada tekanan sistolik, diastolik dan MAP dan perbedaan yang signifikan (p<0.05) pada denyut nadi sesaat setelah laringoskopi intubasi antara kedua grup. Hal ini sesuai dengan teori dimana blok superior laringeus dan transtrakeal menumpulkan sensasi nyeri yang terjadi saat manipulasi jalan nafas seperti laringoskopi intubasi endotrakeal sehingga tidak terjadi stimulasi simpatis yang dapat menimbulkan respons hemodinamik berupa peningkatan tekanan darah dan denyut nadi.…”

Section: Respons Hemodinamikunclassified

Comparison of Intubation Quality and Haemodynamic Response in Endotracheal Intubation Between Superior Laringeus and Transtracheal Block and Muscle Relaxants

Primadita

Murti

Santosa

2018

MNJ

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ABSTRAKLatar Belakang. Tindakan intubasi endotrakeal dapat menstimulasi respons batuk, spasme laring, serta meningkatkan hemodinamik. Obat pelumpuh otot memudahkan intubasi namun tidak menekan respons hemodinamik. Blok superior laringeus dan transtrakeal diduga menghasilkan kualitas intubasi setara obat pelumpuh otot dan mampu menekan peningkatan hemodinamik. Tujuan. Membandingkan kualitas intubasi dan respons hemodinamik yang dihasilkan oleh blok nervus superior laringeus dan transtrakeal dengan obat pelumpuh otot. Metode. Kualitas intubasi diukur menurut Helbo-Hansen Raulo dan Trap Anderson. Tekanan darah, denyut nadi, dan saturasi diukur sebelum intubasi dan setelah intubasi. Hasil. Grup pelumpuh otot (100%) dan satu pasien (5,9%) buruk pada grup blok. Hemodinamik setelah intubasi kedua grup berbeda signifikan (p=<0,05) dengan sistolik (148,35±26,33 vs 109,53±15,98); diastolik (94,88±20,18 vs 68,00±15,54); MAP (109,65±21,18 vs 79,94±16,94); nadi (101,71±16,34 vs 87,47±20,03); kecuali saturasi (99,35±0,79 vs 99,35±0,99) tidak berbeda. Simpulan. Pelumpuh otot dan blok menghasilkan kualitas intubasi yang serupa, namun respons hemodinamik lebih baik pada blok dibanding pelumpuh otot. Kata kunci: Intubasi, blok, superior laringeus, transtrakeal ABSTRACT Background. Endotracheal intubation stimulates various responses such as coughing and bucking, bronchial and laryngeal spasm and hemodynamic changes. Muscle relaxants facilitate easy intubation, but not suppressing hemodynamic response. Superior laryngeus and transtracheal block is presume to suppress hemodynamic changes while maintain intubation quality. Objective. To compare intubation quality and hemodynamic response from superior laryngeus and transtracheal block and muscle relaxants. Methods. Intubation quality is assessed using Helbo-Hansen Raulo and Trap Anderson. Blood Pressure, pulse and saturation were measured before and after intubation. Results. All intubation is acceptable in muscle relaxants group (100%), one unacceptable in block group (5.9%). After intubation hemodynamic in both groups were significantly different (p=<0.05) for systolics (148.35±26.33 vs 109.53±15.98), diastolics (94.88±20.18 vs 68.00±15.54), MAP (109.65±21.18 vs 79.94±16.94), and for pulse (101.71±16.34 vs 87.47±20.03), except for saturation (99.35±0.79 vs 99.35±0.99). Conclusion. Muscle relaxant and block deliver similar intubation quality, however block giving out better hemodynamic response stability.

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Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques

Abstract: In conclusion the 'spray as you go' technique was safe, provided effective local anaesthesia and was preferred by both patients and endoscopists.

Cited by 15 publications

References 15 publications

Comparison between lignocaine nebulization and airway nerve block for awake fiberoptic bronchoscopy-guided nasotracheal intubation: a single-blind randomized prospective study

Comparison between lignocaine nebulization and airway nerve block for awake fiberoptic bronchoscopy-guided nasotracheal intubation: a single-blind randomized prospective study

Awake Fiberoptic Intubation: Comparison Of Three Techniques of Spray-As-You-Go

Comparison of Intubation Quality and Haemodynamic Response in Endotracheal Intubation Between Superior Laringeus and Transtracheal Block and Muscle Relaxants

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