Zhou Yu, Chen Bin, Xiong Yiqiang, Yu Xiangdi
Department of Anesthesiology, Zunyi Medical University, Zunyi, Guizhou, China.
Department of Anesthesiology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou University, Guiyang, Guizhou, China.
Evid Based Complement Alternat Med. 2022 Jun 28;2022:1594829. doi: 10.1155/2022/1594829. eCollection 2022.
In the current study, we assessed the effect of the ultrasound-guided internal branch of the upper laryngeal nerve (USG-guided iSLN) block combined with general anesthesia on perioperative sore throat (POST), cough, hoarseness of voice, intraoperative hemodynamic changes, and the quality of early recovery for the patients undergoing suspension laryngoscopy vocal cord polypectomy (SLVCP).
This was a randomized controlled trail. Eighty patients, aged from 18 to 70 years old, ASA I ∼ II, scheduled for polypectomy of the vocal cord by using a laryngoscope, were randomized into 2 groups ( = 40 each) using a random number table. Patients in group C received general anesthesia (GA), whereas those in group S received USG-guided iSLN block bilaterally (37.5 mg of 0.375% ropivacaine, 5 ml each side) combined with GA. The primary outcome was the quality of patients' recovery using the Quality of Recovery Questionnaire (QoR-9). The secondary outcomes were postoperative cough, sore throat, hoarseness of voice, and hemodynamic changes in both groups at corresponding time points. The adverse reactions such as postoperative chocking, or aspiration, and dyspnea was recorded as well.
The QoR-9 scores of patients in group C were lower than those of group S at time points of D1∼D2 ( < 0.05). Patients in group S had a significantly lower incidence of perioperative cough than those in group C in the early postoperative period (1 hour after extubation) ( < 0.05), the scores of sore throat were lower in group S than those in group C ( < 0.05), the incidence of postoperative hoarseness was increased in group S than that in group C at the time points of 30 min, 2 h, and 4 h after extubation ( < 0.05); however, the incidence of postoperative hoarseness was decreased in group S than that in group C at the time point of 24 h after extubation ( < 0.05). MAP and HR of group S was lower than those of group C at time points of T1∼T4 ( < 0.05). No serious adverse events were observed in both groups.
The study found that the application of ultrasound guided superior laryngeal nerve block combined with general anesthesia for the patients undergoing SLVCP could effectively promote the quality of early recovery. Clinical trial registration: This trial is registered with NCT05309174. The date of registration: March 12th 2021.Trial registry name: The Study of Bilateral Upper Laryngeal Nerve Block for Supporting the Removal of Vocal Cord Polyps Under Laryngoscopy.
在本研究中，我们评估了超声引导下喉上神经内支阻滞（USG-guided iSLN）联合全身麻醉对支撑喉镜下声带息肉切除术（SLVCP）患者围手术期咽痛（POST）、咳嗽、声音嘶哑、术中血流动力学变化及早期恢复质量的影响。
这是一项随机对照试验。80例年龄在18至70岁、ASA I～II级、计划行喉镜下声带息肉切除术的患者，使用随机数字表随机分为2组（每组 = 40例）。C组患者接受全身麻醉（GA），而S组患者接受双侧USG-guided iSLN阻滞（每侧5ml 0.375%罗哌卡因37.5mg）联合GA。主要结局是使用恢复质量问卷（QoR-9）评估患者的恢复质量。次要结局是两组在相应时间点的术后咳嗽、咽痛、声音嘶哑及血流动力学变化。同时记录术后呛咳、误吸及呼吸困难等不良反应。
在D1至D2时间点，C组患者的QoR-9评分低于S组（<0.05）。术后早期（拔管后1小时），S组患者围手术期咳嗽发生率显著低于C组（<0.05），S组咽痛评分低于C组（<0.05），拔管后30分钟、2小时和4小时，S组术后声音嘶哑发生率高于C组（<0.05）；然而，拔管后24小时，S组术后声音嘶哑发生率低于C组（<0.05）。在T1至T4时间点，S组的平均动脉压（MAP）和心率（HR）低于C组（<0.05）。两组均未观察到严重不良事件。
研究发现，超声引导下喉上神经阻滞联合全身麻醉应用于SLVCP患者可有效提高早期恢复质量。临床试验注册：本试验已在NCT05309174注册。注册日期：2021年3月12日。试验注册名称：喉镜下双侧喉上神经阻滞辅助声带息肉切除的研究。
