Ultrasound Guided Superior Laryngeal Nerve Block Compared With Blind Block Technique

Study Overview
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Brief Summary
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The aim of this study is to evaluate the effect of ultrasound guided technique for block of internal branch of superior laryngeal nerve in surgical patient in comparison to blind anatomical technique.

Detailed Description
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Airway anesthesia is pivotal for successful awake intubation provided either topically or by nerves blocks. Airway blocks are technically harder to perform with more complications possibilities. However, in experienced hands, they can be useful as they provide better intubating conditions.

Official Title
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Ultrasound Guided Bilateral Superior Laryngeal Nerve Block Compared With Blind Block Technique For Awake Fibre-optic Intubation In Suspected Difficult Intubation

Conditions
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Airway Complication of Anesthesia

Intervention / Treatment
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* Device: ultrasound technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists ( ASA ) physical status I and II. Age between 40-60 years. Modified Mallampati class III-IV . Exclusion Criteria: Local pathology of the neck. Bleeding diathesis. Allergy to local anesthetic agent. Intellectual impairment. Psychiatric disease. Body mass index ≥30 kg/m2.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ultrasound group<br>patient using ultrasound technique.probe will be placed over submandibular area, the thyrohoid muscle and thyrohyoid membrane will be identified between greater horn fo hyoid bone and thyroid cartilage , 3 ml of lignocaine will be placed on space between thim and the procedure will repeated on contra lateral side. | Device: ultrasound technique<br>* evaluate the effect of ultrasound guided technique for block of internal branch of superior laryngeal nerve<br>|
| Active Comparator: anatomical blind group<br>patient using anatomical land mark technique, internal branch of superior laryngeal nerve will be blocked slightly anterior to greater horn of hyoid bone . by 3 ml lignocaine . the procdure will be repeated on contra lateral side . | Device: ultrasound technique<br>* evaluate the effect of ultrasound guided technique for block of internal branch of superior laryngeal nerve<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| assessment the quality of airway anesthesia | The Quality of Airway anesthesia will be graded as: 0 = no coughing or gagging in response to intubation, 1 = mild coughing or gagging that will not hinder intubation, 2 = moderate coughing or gagging that will interfere minimally with intubation,3 = severe coughing or gagging that make intubation difficult and 4 = very severe coughing or gagging that will require additional local anesthetic or change in technique to achieve successful intubation. | Up to 2 years post baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Suspected Difficult Intubation