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

Pooja Rawat Mathur; Neena Jain; Aji Kumar; Beena Thada; Veena Mathur; Deepak Garg

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자료유형: 학술저널

저자정보: Pooja Rawat Mathur (Jawaharlal Nehru Medical College) Neena Jain (Jawaharlal Nehru Medical College) Aji Kumar (Jawaharlal Nehru Medical College) Beena Thada (Jawaharlal Nehru Medical College) Veena Mathur (Jawaharlal Nehru Medical College) Deepak Garg (Jawaharlal Nehru Medical College)

저널정보: 대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.71 No.2

발행연도: 2018.1

수록면: 120 - 126 (7page)

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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.

참고문헌 (16)

참고문헌 신청

Panchabhai TS / 2015 / Historical perspectives of bronchoscopy. Connecting the dots / Ann Am Thorac Soc 12:631~641

Yrigoyen E / 1975 / Flexible fiberoptic bronchoscopy. Anesthesia, technique and results / West J Med 122:117~122

Diaz-Jimenez JP / 2013 / Interventions in Pulmonary Medicine / Springer :13~31

Parkes SB / 1997 / Plasma lignocaine concentration following nebulization for awake intubation / Anaesth Intensive Care 25:369~371

Dhasmana SC / 2014 / Nasotracheal fiberoptic intubation: patient comfort, intubating conditions and hemodynamic stability during conscious sedation with different doses of dexmedetomidine / J Maxillofac Oral Surg 13:53~58

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