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超声引导下喉上神经阻滞与传统方法用于声门上肿物直接喉镜活检的比较:一项临床试验

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

作者信息

Sehat-Kashani Saloome, Zandi Parvaneh, Ahmadi Aslan, Derakhshan Pooya, Hassani Valiollah

机构信息

Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.

Department of Anesthesia, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Pain Med. 2022 Dec 11;12(6):e122943. doi: 10.5812/aapm-122943. eCollection 2022 Dec.

Abstract

BACKGROUND

A bilateral superior laryngeal nerve block (SLNB) can provide complete anesthesia for laryngeal sampling and by providing this block we can manage the biopsy of supraglottic masses without the complications of general anesthesia.

OBJECTIVES

This study aimed to compare 2 superior laryngeal nerve block (SLNB) methods using ultrasound and the traditional method for direct laryngoscopic surgery for the biopsy of supraglottic masses.

METHODS

In this single-blind clinical trial, 50 patients undergoing supraglottic laryngeal mass biopsy under direct laryngoscopy were divided into 2 groups. The first group was anatomical landmark bilateral SLNB (C group), and the second group was sono-guided bilateral SLNB (U group). Hemodynamic changes, pain, oxygen desaturation, surgeon satisfaction, and the complication obtained and noted.

RESULTS

There was no significant difference in the success rate of the procedure (P = 0.99), as well as the surgeon's satisfaction with the procedure (P = 0.337). Mean arterial pressure (MAP), oxygen saturation, and their changes in the studied groups were compared before the block, after the block, after the biopsy, and in the recovery room, showing no significant difference between the 2 groups (P > 0.05). Only the heart rate (HR) after the biopsy and in the recovery room showed significant differences between the 2 groups (P < 0.05). There was no significant difference between the 2 groups in the level of patient and surgeon satisfaction and pain during and after the procedure (P > 0.005).

CONCLUSIONS

SLNB for direct laryngoscopic surgery for biopsy of supraglottic masses using ultrasound was not significantly superior to the traditional method, and there was no significant difference between the 2 methods in terms of procedure success, surgeon's satisfaction, and patients' pain.

摘要

背景

双侧喉上神经阻滞(SLNB)可为喉部取样提供完全麻醉,通过实施这种阻滞,我们可以在不发生全身麻醉并发症的情况下进行声门上肿物的活检。

目的

本研究旨在比较两种使用超声的喉上神经阻滞(SLNB)方法与传统直接喉镜手术方法用于声门上肿物活检的情况。

方法

在这项单盲临床试验中,50例接受直接喉镜下声门上喉部肿物活检的患者被分为两组。第一组是解剖标志法双侧SLNB(C组),第二组是超声引导下双侧SLNB(U组)。记录血流动力学变化、疼痛、氧饱和度下降情况、外科医生满意度以及所发生的并发症。

结果

手术成功率(P = 0.99)以及外科医生对手术的满意度(P = 0.337)方面无显著差异。比较了两组在阻滞前、阻滞后、活检后以及恢复室时的平均动脉压(MAP)、氧饱和度及其变化,两组间无显著差异(P > 0.05)。仅活检后及恢复室时的心率(HR)在两组间存在显著差异(P < 0.05)。两组在患者及外科医生满意度水平以及手术期间和术后的疼痛方面无显著差异(P > 0.005)。

结论

使用超声进行直接喉镜手术活检声门上肿物的SLNB并不显著优于传统方法,两种方法在手术成功率、外科医生满意度和患者疼痛方面无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ec5/10016113/8eae6f3eb4b4/aapm-12-6-122943-g001.jpg

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