COMPARISION OF ULTRASOUND AND LANDMARK GUIDED TECHNIQUE FOR SUPERIOR LARYNGEAL NERVE BLOCK AND GLOSSOPHARYNGEAL NERVE BLOCK TO AID AWAKE FIBREOPTIC INTUBATION

Abstract

Background: Awake intubation elicits airway and hemodynamic responses and results in patient pain. Effective airway anaesthesia is crucial for effective airway examination and intubation.

Materials and methods: Thirty members of the American Society of Anaesthesiologists’ physical status I–II patients, ages 18–60, who were going to have awake fiber-optic intubation were put into one of two groups: the landmark group (L, n = 15) or the ultrasound group (U, n = 15). All of the patients were given a nebulized 4% lignocaine (3 mL) dose and a Trans tracheal shot of 2% lignocaine (3 mL). The primary outcome is the quality of the airway anaesthesia, which is measured by the lack of airway reflexes during the procedure. Secondary outcomes measured were the time taken for performing the procedure, effects on haemodynamic variables and patient perception of pain and discomfort during intubation

Results: Group U experienced significantly higher-quality anaesthesia than Group L (P < 0.001). Group U had a shorter mean intubation time (4.6 ± 0.7 mins) than Group L (5.6 ± 0.8 mins, P < 0.001). In Group L, there was a substantial rise in heart rate, mean arterial pressure, and patient perception of pain.

Conclusion: As part of the preparation for awake fiber-optic intubation, ultrasound for glossopharyngeal nerve block and ibSLN block enhances patient tolerance and the quality of airway anaesthesia.