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

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

doi:10.4097/kjae.2018.71.2.120

Cited by 33 publications

(37 citation statements)

References 16 publications

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“…One recent similar study concluded that airway anesthesia using airway nerve blocks is superior to lignocaine nebulization for awake fiberoptic bronchoscopy-guided nasotracheal intubation, in terms of ease of intubation, less intubation time and patient comfort and satisfaction. But in that study authors used jet nebulization and blind airway nerve block whereas in present study ultrasonic nebulisation and ultrasound guided nerve block was used 11 .…”

Section: Discussionmentioning

confidence: 89%

Anaesthesia for Awake Fiberoptic Intubation: Ultrasound-Guided Airway Nerve Block versus Ultrasonic Nebulisation with Lignocaine

Mohanta¹,

Kumar²,

Kaushal³

et al. 2021

Discoveries (Craiova)

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Background: In anticipated difficult airway, awake fiberoptic guided intubation should be the ideal plan of management. It requires sufficient upper airway anesthesia for patient’s comfort and cooperation. We compared the efficacy of ultrasound guided airway nerve blocks and ultrasonic nebulisation with lignocaine for airway anesthesia before performing awake fibreoptic guided intubation. Methods: This prospective, randomised study included sixty consenting adult patients of both genders (American Society of Anesthesiologists' physical status 1–3) with anticipated difficult airway undergoing surgery. Ultrasound guided airway nerve blocks group received ultrasound-guided bilateral superior laryngeal (1 ml of 2% lignocaine) and transtracheal recurrent laryngeal (2 ml of 2% lignocaine) airway nerve blocks and ultrasonic nebulisation with lignocaine group received ultrasonic nebulisation of 4 ml of lignocaine 4%. The primary outcome was to compare the time required to intubate, whereas the secondary outcomes were to compare cough reflex and gag reflex, hemodynamic changes, number of attempts required, and comfort score during awake fibreoptic guided intubation in both the groups. Results: The time taken for intubation was significantly lower in the ultrasound guided airway nerve blocks group 69.2721.85 s than ultrasonic nebulisation with lignocaine group 92.43  42.90 s (p = 0.015). Hemodynamic variables changed during the procedure but the values were comparable in both groups. There were no statistical differences in cough and gag reflexes, number of attempts, and comfort score in both groups. Conclusions: This study shows that significant lesser time required for performing awake fiberoptic intubation when patient received ultrasound guided airway nerve block in comparison to ultrasonic nebulisation for airway anaesthesia.

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Section: Discussionmentioning

confidence: 89%

Anaesthesia for Awake Fiberoptic Intubation: Ultrasound-Guided Airway Nerve Block versus Ultrasonic Nebulisation with Lignocaine

Mohanta¹,

Kumar²,

Kaushal³

et al. 2021

Discoveries (Craiova)

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“…Based on a previous study by Mathur et al [18] who reported 30% difference in the intubation time, a total sample size of 50 patients (25 patients in each group) enables us to reject the null hypothesis that the failure rates for study and control subjects are equal with probability (power) of 0.80, when type I error probability associated with this test is 0.05, after adding 20% for possible dropout of patients.…”

Section: Sample Sizementioning

confidence: 99%

Airway nerve blocks as an adjunct to lignocaine nebulization for awake fiberoptic intubation

Hassanein

Talaat

Shehatah

2020

Egyptian Journal of Anaesthesia

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Background: Awake tracheal intubation (ATI) is becoming a gold standard in managing the difficult airway. Airway anesthesia is the cornerstone for the preparation of awake fiberoptic intubation (AFOI). Many topical and regional techniques have been developed to attenuate airway reflexes and facilitate AFOI. Glossopharyngeal superior laryngeal and recurrent laryngeal nerves must be blocked to attain adequate reflex abolishment. Aim: This randomized controlled prospective study was performed to evaluate the effectiveness of adding airway nerve blocks to lignocaine nebulization for nasal AFOI. Methodology: This was a comparative study conducted in 50 patients randomly allocated into two groups of 25 each: Group A and Group B; both received nebulization of 2% lignocaine 10 mL. Group B was then given airway blocks as bilateral superior laryngeal (2% lignocaine 1.5 mL each) and transtracheal (2% lignocaine 2 mL) block. Group A received the same airway nerve block by the same volume with normal saline 0.9%. Two puffs of 10% lignocaine to the nose and postnasal space on each side were given to both groups. Awake nasal fiberoptic intubation was performed. Vital parameters, such as intubation time, intubation condition, patient comfort scale, satisfaction score, and side effects, were recorded. Statistical analysis for both groups was done. Results: Statistically, no significant differences were found in demographics and hemodynamics. Regarding intubation time and intubation condition scale, there was a significant improvement in Group B than in Group A. Also, overall patient comfort and satisfaction scores were significantly better in Group B than in Group A. Conclusion:Upper airway lignocaine nebulization may provide adequate anesthesia for AFOI, but when supplemented by airway nerve blocks, it improves the quality of anesthesia and patient satisfaction.

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“…It would be safe and not unpleasant for the patient and would at the same time provide acceptable conditions for the bronchoscopist. (Mathur et al, 2018) Hence, this study aims to compare local anesthetic application techniques, i.e., airway nerve blocks and "Spray as you go" technique for patients undergoing awake beroptic intubation.…”

Section: Introductionmentioning

confidence: 99%

Localanaestesia for Awake Fiberoptic Intubation: A Comparison of Two Techniques- Airway Nerve Blocks vs 'Spray as You Go' Technique

Mankar

Saundattikar

2020

IJAR

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Background- Awake fiberoptic intubation is the recommended technique for anticipated difficult airway management which requires effective local anesthesia for patient's comfort and co-operation. In this study, we compared airway nerve blocks and “Spray as you go” technique for awake fiberoptic intubation in difficult airway patients. Method- Sixty adult patients with an anticipated difficult airway with Mallampati Class III and IV were selected and randomized into two groups for awake fiberoptic intubation. Each group receiving lignocaine as a local anesthetic with either of two different methods. Group A (n=30) via airway nerve blocks using transtracheal and superior laryngeal nerve block; and group B (n=30) via intubating fiberscope using ‘spray as you go’ technique. We compared two groups using the Number of attempts for intubation, Intubation time, Intubating conditions, Cough count, Hemodynamic response, Severity scale [patients comfort], and the additional required dose of lignocaine used. Descriptive statistics were done for all data. p-value<0.05 was considered statistically significant. The result- we found that airway nerve blocks provide better local anesthesia by providing good intubating conditions with less cough count, less intubation time, and better hemodynamic stability as compare to spray as you go group. None of the patients showed any evidence of lignocaine toxicity. But an additional dose of lignocaine used was significantly more number of patients in the spray as you go, group. However patient comfort and acceptance is equal in both groups as patient severity score was the same in both groups and all patients got successfully intubated in both the groups Conclusion- airway nerve block technique of local anesthesia is better than spray as you go method however spray as you go technique can be used in cases where airway blocks are not possible.

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

Cited by 33 publications

References 16 publications

Anaesthesia for Awake Fiberoptic Intubation: Ultrasound-Guided Airway Nerve Block versus Ultrasonic Nebulisation with Lignocaine

Anaesthesia for Awake Fiberoptic Intubation: Ultrasound-Guided Airway Nerve Block versus Ultrasonic Nebulisation with Lignocaine

Airway nerve blocks as an adjunct to lignocaine nebulization for awake fiberoptic intubation

Localanaestesia for Awake Fiberoptic Intubation: A Comparison of Two Techniques- Airway Nerve Blocks vs 'Spray as You Go' Technique

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