Original Research: Aerosolized Lidocaine: Effective for Safer Arousal After Suspension Laryngoscopy

Paltura, Ceki; Güvenç, Ahmet; Develioğlu, Ömer Necati; Yelken, Kürşat; Külekçi, Mehmet

doi:10.1016/j.jvoice.2018.08.012

Cited by 11 publications

(11 citation statements)

References 10 publications

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“…In most patients, these hemodynamic responses are transient; however, in patients with cardiovascular and/or cerebrovascular diseases, these responses might produce dangerous complications ( 25 ). Patients undergoing suspension laryngoscopic surgery encounter the same cardiac reaction secondary to the sympathetic reflex and release of catecholamines, even though the stimulation is much more intensive and is sustained much longer than the transient process of endotracheal intubation ( 26 , 27 ). Paltura et al demonstrated that aerosolized lidocaine could inhibit the sympathetic reflex and block the SLN to effectively improve hemodynamics ( 27 ), and the effects of SLNB were proven in our study again.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Block of the Internal Branch of the Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Suspension Laryngoscopic Surgery: A Prospective Randomized Trial

et al. 2022

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ObjectiveSuspension laryngoscopy is commonly used in operative laryngology. Although it is efficient and minimally invasive in most cases, it can lead to postoperative sore throat (POST) and cough. Because of intensive stimulation by the rigid metal suspension laryngoscope, procedures must be implemented under general anesthesia. Together, these factors increase the possibility of postoperative complications. Blocking the internal branch of the superior laryngeal nerve (SLN) is useful in inhibiting the endotracheal intubation stress response. Thus, we evaluated the efficacy of ultrasound-guided block of the internal branches of the superior laryngeal nerve to improve postoperative complications.MethodsA total of 64 patients was scheduled for elective laryngeal cancer resection, and suspension laryngoscopic surgery was performed under general anesthesia with a block of the internal branch of the superior laryngeal nerve (group iSLNB, n = 32) and without a block (group C, n = 32). Patients in group iSLNB received ultrasound-guided blocks of the internal branches of superior laryngeal nerve bilaterally (0.2% ropivacaine, 2 ml each side). The primary outcome measures were the incidence and severity of sore throat and cough assessed 0.5, 2, 6, and 24 h after tracheal extubation. The secondary outcome measures were heart rate and mean arterial pressure on arrival in the operating room (T0), at endotracheal intubation (T1), upon insertion of the suspension laryngoscope (T2), 5 min after insertion (T3), at tracheal extubation (T4), and 5 min after extubation (T5). Blood glucose levels were measured at T0, T3, and T5.ResultsThe incidence and severity of POST and cough in the iSLNB (internal branch of superior laryngeal nerve block) group were significantly reduced within 6 h after extubation compared with those in the control group, regardless of whether swallowing was present (P < 0.05). Compared to the control group from T0–T5, except at T0, the iSLNB group had significantly lower heart rate and mean arterial pressure (P < 0.05). Compared to T0, at other time points, the heart rates in the control group were significantly increased (P < 0.05), and the mean arterial pressures at other time points in the iSLNB group were significantly lower than those at T0 (P < 0.05). The blood glucose levels at T3 and T5 in the iSLNB group were significantly reduced compared with those in the control group (P < 0.05).ConclusionUltrasound-guided block of the internal branch of the superior laryngeal nerve might effectively ameliorate postoperative complications secondary to suspension laryngoscopic surgery with endotracheal intubation under general anesthesia and improve hemodynamic stability.Clinical Trial Registrationhttps://www.chictr.org.cn, identifier: ChiCTR2100049801.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Block of the Internal Branch of the Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Suspension Laryngoscopic Surgery: A Prospective Randomized Trial

et al. 2022

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“…SLVCP is the category of minor surgery, and the patients wish to recover quicky to be back to their normal life. However, the most patients undergoing SLVCP are often disturbed by cough, sore throat, and hoarseness [ 4 ], and the complications after surgery are not conducive to the patients' recovery [ 19 ]. Although the occurrence of postoperative cough, sore throat, and hoarseness of voice can be reduced by choosing a smaller type of an endotracheal tube, using appropriate pressure of tracheal cuff, intravenous or topical lidocaine [ 20 ], lidocaine into the endotracheal tube cuff [ 21 ], and anti-inflammatory agents such as steroids [ 8 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Grade 0: no cough Grade 1: light or single cough Grade 2: more than one episode of unsustained (65 s) coughing Grade 3: sustained (65 s) and repetitive cough with the left head Sore throat severity Grade 0: no sore throat Grade 1: mild (complained of sore throat only upon inquiry) Grade 2: moderate (complained of sore throat on his/her own) Grade 3: severe (severe pain associated with a marked change in voice) Hoarseness severity Grade 0: none Grade 1: noted by the patient Grade 2: obvious to the observer Grade 3: aphonia 4 Evidence-Based Complementary and Alternative Medicine adrenergic antagonists [24,25]. However, the stress response could not be inhibited effectively by these approaches.…”

Section: Cough Severitymentioning

confidence: 99%

“…Patients complained of hoarseness, voice fatigue, double tone, and inability to project sounds [ 3 ]. Suspension laryngoscopy vocal cord polypectomy (SLVCP) is commonly used to diagnose or treat benign or malignant diseases of the vocal cords [ 4 ]. To avoid the movement of cords, coughing, or bucking, the procedure is performed under general anesthesia, in which the adequate muscle relaxation and immobile vocal cords could meet the surgical requirement [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy of Ultrasound-Guided Superior Laryngeal Nerve Block as an Adjuvant to General Anesthesia during Suspension Laryngoscopy Vocal Cord Polypectomy

Zhou

Chen

Xiong

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. In the current study, we assessed the effect of the ultrasound-guided internal branch of the upper laryngeal nerve (USG-guided iSLN) block combined with general anesthesia on perioperative sore throat (POST), cough, hoarseness of voice, intraoperative hemodynamic changes, and the quality of early recovery for the patients undergoing suspension laryngoscopy vocal cord polypectomy (SLVCP). Methods. This was a randomized controlled trail. Eighty patients, aged from 18 to 70 years old, ASA I ∼ II, scheduled for polypectomy of the vocal cord by using a laryngoscope, were randomized into 2 groups (n = 40 each) using a random number table. Patients in group C received general anesthesia (GA), whereas those in group S received USG-guided iSLN block bilaterally (37.5 mg of 0.375% ropivacaine, 5 ml each side) combined with GA. The primary outcome was the quality of patients’ recovery using the Quality of Recovery Questionnaire (QoR-9). The secondary outcomes were postoperative cough, sore throat, hoarseness of voice, and hemodynamic changes in both groups at corresponding time points. The adverse reactions such as postoperative chocking, or aspiration, and dyspnea was recorded as well. Results. The QoR-9 scores of patients in group C were lower than those of group S at time points of D1∼D2 ( P < 0.05 ). Patients in group S had a significantly lower incidence of perioperative cough than those in group C in the early postoperative period (1 hour after extubation) ( P < 0.05 ), the scores of sore throat were lower in group S than those in group C ( P < 0.05 ), the incidence of postoperative hoarseness was increased in group S than that in group C at the time points of 30 min, 2 h, and 4 h after extubation ( P < 0.05 ); however, the incidence of postoperative hoarseness was decreased in group S than that in group C at the time point of 24 h after extubation ( P < 0.05 ). MAP and HR of group S was lower than those of group C at time points of T1∼T4 ( P < 0.05 ). No serious adverse events were observed in both groups. Conclusion. The study found that the application of ultrasound guided superior laryngeal nerve block combined with general anesthesia for the patients undergoing SLVCP could effectively promote the quality of early recovery. Clinical trial registration: This trial is registered with NCT05309174. The date of registration: March 12th 2021.Trial registry name: The Study of Bilateral Upper Laryngeal Nerve Block for Supporting the Removal of Vocal Cord Polyps Under Laryngoscopy.

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“…Tracheal administration of lidocaine can potentially reduce pain, cough reflex, bronchospasm, vagal reflex, and hypertension (11). However, the efficacy of this intervention has not been investigated after congenital heart surgery, to the best of our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Aerosolized lidocaine does not confer benefit as an add-on therapy to reduce respiratory therapy-associated pain after pediatric congenital heart surgery: a randomized, double-blind, placebo-controlled trial

Silva¹

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Original Research: Aerosolized Lidocaine: Effective for Safer Arousal After Suspension Laryngoscopy

Cited by 11 publications

References 10 publications

Ultrasound-Guided Block of the Internal Branch of the Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Suspension Laryngoscopic Surgery: A Prospective Randomized Trial

Ultrasound-Guided Block of the Internal Branch of the Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Suspension Laryngoscopic Surgery: A Prospective Randomized Trial

The Efficacy of Ultrasound-Guided Superior Laryngeal Nerve Block as an Adjuvant to General Anesthesia during Suspension Laryngoscopy Vocal Cord Polypectomy

Aerosolized lidocaine does not confer benefit as an add-on therapy to reduce respiratory therapy-associated pain after pediatric congenital heart surgery: a randomized, double-blind, placebo-controlled trial

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