Comparison of efficacy of lignocaine anesthesia of vocal cords by [spray as you go] through a bronchoscope with lignocaine injection through the cricothyroid membrane

ABSTRACT

To assess and compare the efficacy of lignocaine anesthesia of vocal cords by [spray as you go] through a bronchoscope with lignocaine injection through the cricothyroid membrane. Quasi experimental study. This study was done in Combined Military Hospital Peshawar form May 2009 to June 2010. Thirty patients in each group were given local anesthesia to the vocal cords. With lignocaine either via intratracheal instillation through the cricothyroid membrane or through a fibreoptic bronchoscope [spray as you go]. A cough score was calculated by recording the number of coughs as the bronchoscope was advanced through the cords into the trachea. A twenty point unpleasantness score was marked by the patient 2 hours after the procedure. Cough score and unpleasantness score was compared among the two groups using SPSS version 19. Median unpleasantness score was 6 [Inter quartile range [IQR] 4-8] whereas median cough score was 2[IQR 0-3]. The difference was statistically significant among the two groups for both cough and unpleasant scores [p < 0.001 and p < 0.001 respectively]. Intratracheal injection of lignocaine is more comfortable for the patient. It induces much less cough and irritability to the patient than the [spray as you go] technique