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AJAIC-Alexandria Journal of Anaesthesia and Intensive Care. 2006; 9 (4): 44-51
in English | IMEMR | ID: emr-201505

ABSTRACT

Background and Objectives: The main objectives of anesthesia for laryngeal surgery are to provide the surgeon with immobile field with enough space for the rigid Iaryngoscope. Secured airway and ventilation, together with haemodynamic stability. It is equally important to promote rapid awakening and return of protective airway reflexes and to prevent possible respiratory complications such as cough, stridor, and laryngospasm. The aim of this study was to compare the effects of three different drugs given by nebulizing techniques administered in the immediate preoperative period. We compared dexamethazone, racemic epinephrine and lidocaine effects on postoperative respiratory complications and recovery after short-term laryngeal surgery in adults


Materials and Methods: Eighty ASA I-II patients aged 18-55 years of either sex scheduled for minor laryngeal surgery were included in this prospective, placebo-controiied, randomized, and double-blinded study. Patients were randomly allocated into four even groups according to the nebulized drug given, 20 patients each: Group I: 0.9% Normal Saline [control group], Group II: Dexamethazone 0.5 mg/kg, Group III; Racemic Epinephrine 2.25 % 0.01 ml/kg and Group IV; Lidocaine 1.5 mg/kg. All the drugs were prepared in 5 ml solution and given over 10 min periods by nenulizer in the holding area before shifting the patient to the OR. Recovery time has been recorded. Postoperative respiratory complications were assessed using Postoperative Respiratory System Evaluation Scoring [PRSES] at 1, 5, 10 minutes after removal of the rigid Iaryngoscope


Results: The occurrence of PRSES-1 [indicates no respiratory complications] was Significantly more frequent in group III [R-epinephrine] and group IV [lidocaine] in Comparison to both group I [control] and group II [dexamethazone] at the 1st, 5th, and 10th min after recovery. However, the frequency of PRSES-1 in group IV was significantly higher than group III, at all evaluation times. Dexamethazone group recorded significant prolonged recovery time compared to R-epinephrine group III. However it was insignificantly prolonged compared to both groups I and IV. Therefore, Patients of lidocaine group showed better recover criteria and lower incidence of respiratory complications compared to the other study groups


Conclusions: Nebulization of Lidocaine in the immediate preoperative period is very effective in reducing postoperative respiratory complications after short-term laryngeal surgery by way of rigid Iaryngoscope

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