A clinical study of ultrasound-guided internal branch of superior laryngeal nerve block to treat postoperative sore throat after extubation under general anesthesia

Meirong Wang, Huibi Ooyang, Yicheng Lin, Zhipeng Li, M. He, Chui-liang Liu
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Abstract

Objective To investigate the efficacy of ultrasound-guided internal branch of superior laryngeal nerve (ibSLN) block to treat postoperative sore throat (POST) after extubation under general anesthesia. Methods Sixty patients, aged from 18 to 45 years old, American Society of Anesthesiologist (ASA) Ⅰ or Ⅱ who suffered from moderate to severe postoperative sore throat after extubation under general anesthesia were selected. They were divided into two groups according to the random number table method (n= 30): a lidocaine combined with budesonide aerosol inhalation group (group L) and an iBSLN block group (group S). The Visual Analogue Scale (VAS) scores and the significant analgesic efficiency rate of POST were recorded in two groups immediately before treatment (T0), 10 min after treatment (T1), 30 min after treatment (T2), 1 h after treatment (T3), 2 h after treatment (T4), 4 h after treatment (T5), 8 h after treatment (T6), and 24 h after treatment (T7). The mean arterial pressure (MAP), heart rate, and pulse oxygen saturation (SpO2) were also recorded from T0 to T7. Adverse reactions such as chocking on water, regurgitation and aspiration, hoarseness and dyspnea were observed in the two groups, while the score of patient satisfaction towards treatment was evaluated. Results The VAS score of POST in group S was lower than that in group L from T0 to T6 (P<0.05). The significant analgesic efficiency rate of POST in group S was significantly higher than that in group L from T1 to T6 (P<0.05). Compared with group L, heart rate in group S reduced from T1 to T4 (P<0.05), while MAP decreased from T1 to T3 (P<0.05). The satisfaction score of group S was higher than that of group L (P< 0.05). No chocking on water, regurgitation and aspiration, hoarseness, and dyspnea was found in the two groups. Conclusions Ultrasound-guided ibSLN block can effectively treat POST after extubation under general anesthesia, with remarkably improved analgesic effects in comparison with traditional methods where hormone combined with local anesthetic aerosol are inhaled. It provides a good approach to treat POST after extubation under general anesthesia. Key words: Ultrasound-guided; Superior laryngeal nerve; Nerve blocking anesthesia; Postoperative sore throat; Anesthesia, general
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超声引导下喉上神经内支阻滞治疗全麻拔管后咽喉痛的临床研究
目的探讨超声引导下喉上神经内支阻滞治疗全麻拔管后咽喉痛的疗效。方法选择全麻拔管术后出现中重度咽痛的患者60例,年龄18 ~ 45岁,美国麻醉学会(ASA)Ⅰ或Ⅱ会员。按随机数字表法分为两组(n= 30):1例利多卡因联合布地奈德雾化吸入组(L组)和1例iBSLN阻滞组(S组)。记录两组患者治疗前即刻(T0)、治疗后10 min (T1)、治疗后30 min (T2)、治疗后1 h (T3)、治疗后2 h (T4)、治疗后4 h (T5)、治疗后8 h (T6)、治疗后24 h (T7)的视觉模拟评分(VAS)和POST的显著镇痛有效率。T0 ~ T7期间记录平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO2)。观察两组患者出现呛水、反流误吸、声音嘶哑、呼吸困难等不良反应,并评价患者对治疗的满意度。结果T0 ~ T6时,S组POST VAS评分低于L组(P<0.05)。T1 ~ T6期间,S组POST的显著镇痛有效率显著高于L组(P<0.05)。与L组比较,S组T1 ~ T4心率降低(P<0.05), MAP降低(P<0.05)。S组患者满意度评分高于L组(P< 0.05)。两组患儿均无呛水、反流误吸、声音嘶哑、呼吸困难。结论超声引导下ibSLN阻滞可有效治疗全麻拔管后POST,与传统吸入激素联合局麻气雾剂的方法相比,其镇痛效果明显改善。为全麻拔管后POST的治疗提供了良好的途径。关键词:超声引导;喉上神经;神经阻滞麻醉;术后喉咙痛;麻醉,一般
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