Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

Abstract

Introduction Ultrasound-guided internal branch of the upper laryngeal nerve block (USG-guided iSLN block) have been used to decrease the perioperative stress response of intubation. It is more likely to be successful than blindly administered superior laryngeal nerve blocks with fewer complications. Here, we evaluated the efficacy of USG-guided iSLN block to treat postoperative sore throat (postoperative sore throat, POST) after extubation. Methods 100 patients, aged from 18 to 60 years old, ASA I~II who underwent general anesthesia and suffered from the moderate to severe postoperative sore throat after extubation were randomized into two groups(50 cases per group). Patients in group S received USG-guided iSLN block bilaterally (60mg of 2% lidocaine, 1.5ml each side), whereas those in group I received inhalation with 100 mg of 2% lidocaine and 1mg of budesonide suspension diluted with normal saline (oxygen flow 8 L /min, inhalation for 15 minutes). The primary outcome were VAS scores in both groups before treatment (T0), 10 min (T1), 30 min(T2), 1h(T3), 2 h(T4), 4h(T5), 8h(T6), 24h(T7), and 48h(T8) after treatment. The secondary outcome were satisfaction scores after treatment, MAP, HR, and SPO2 fromT0 to T8. The adverse reactions such as postoperative chocking or aspiration, cough, hoarseness, dyspnea were also observed in both groups. Results Patients in group S had significantly lower VAS score than that in group I at points of T1 ~ T6 (P < 0.01). HR of group S was lower than that of group I at points of T1 ~ T2and T4 (P < 0.05), and MAP was lower than that of group I at points of T1 ~ T3 (P < 0.05). Satisfaction scores of group S were higher than that of group I (P <0.05), In group S, 2 case (4%) needed to intravenous Flurbiprofen Injection 50 mg to relieve pain; in group I, 13 cases (26%) received Flurbiprofen Injection. 2 case of group S appeared throat numbness after treatment for 3 hours; 2 patients have difficult in expectoration after treatment recovered after 3hour. No serious adverse events were observed in both groups. Conclusion Compared with inhalation, USG-guided iSLN block may effectively relieve the postoperative sore throat after extubation under general anesthesia and provided an ideal treatment for POST in clinical work.

A randomised controlled trial of 7.5‐mm and 7.0‐mm tracheal tubes vs. 6.5‐mm and 6.0‐mm tracheal tubes for men and women during laparoscopic surgery

“…Anaesthetist experience was not associated with the rate of sore throat, consistent with another study [21]. We think that tracheal intubation with smaller tubes is an easier intervention than others tested to reduce postoperative sore throat, such as drugs or laryngeal nerve block [22][23][24][25][26][27].…”

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

“…Superior laryngeal nerve block is known to have great value in laryngopharyngeal surgery ( 22 ). Recently, it was also proven to improve POST after general anesthesia ( 23 ). In patients undergoing bronchoscopy examination, this technique could increase comfort and reduce complications, such as hypoxemia and cough ( 15 ).…”

Comparison of Ultrasound-Guided Superior Laryngeal Nerve Block with the Traditional Method for Direct Laryngoscopic Biopsy of Supraglottic Masses: A Clinical Trial

“…In China, Zhipeng et al showed that Ultrasound guided SLNB might successfully decrease the postoperative sore throat after extubation under general anesthesia (13). It is noteworthy that in the present study, the reason for higher HR after the biopsy and in the recovery room in the anatomical landmark group could indicate a better block with ultrasound, but they observed sore throat after general anesthesia, and we evaluated direct laryngoscopy of the supraglottic mass.…”