Improved efficacy of ultrasoud-guided superior laryngeal nerve block in elderly patients undergoing short surgery with general anesthesia / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the improved efficacy of ultrasonography-guided superior laryngeal nerve block (SLNB) in elderly patients undergoing short surgery with general anesthesia.Methods:Sixty-four patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective percutaneous balloon compression under general anesthesia, were divided into 2 groups ( n=32 each) using a random number table method: control group (group C) and ultrasound-guided SLNB group (group S). The patients received bilateral SLNB under ultrasound guidance, and 1% lidocaine 3 ml was injected on each side in group S, while the equal volume of normal saline was given instead in group C. Anesthesia was induced with midazolam, sufentanil, etomidate and mivacurium, and then the patients were mechanically ventilated after endotracheal intubation.Anesthesia was maintained with propofol, remifentanil, and sevoflurane.Cardiovascular response to endotracheal intubation was defined as SBP or HR increased by more than 30% of baseline from the time point immediately after intubation to 2 min after intubation, and the occurrence was recorded.Venous blood samples were collected to detect the plasma concentrations of norepinephrine and cortisol before anesthesia induction and at 5 min after intubation.The development of bucking was recorded during emergence, and the time of tracheal extubation and occurrence of sore throat, throat numbness and hoarseness after tracheal extubation were recorded. Results:Compared with group C, the incidence of cardiovascular response to endotracheal intubation was significantly decreased, the plasma concentrations of norepinephrine and cortisol were decreased at 5 min after intubation, and the incidence of bucking during emergence and sore throat after tracheal extubation was decreased in group S ( P<0.05). Conclusions:Ultrasound-guided SLNB can inhibit the stress response during endotracheal intubation and reduce the occurrence of adverse events during emergence in elderly patients undergoing short surgery with general anesthesia.