Efficacy Of Ultrasound-guided Internal Branch Of Superior Laryngeal Nerve Block On Postoperative Sore Throat After General Anesthesia With Tracheal Intubation

Objective To explore the more effective way to treat postoperative sore throat（postoperative sore throat,POST）after general anesthesia extubation.Compared the application of ultrasound visual guidance under the medial branch of the upper laryngeal nerve in the treatment of sore throat after general anesthesia extubation with aerosol inhalation.Through the development and research of this project,it provides a reference for reducing the incidence of post after general anesthesia Extubation,and provides a good analgesic plan for the treatment of sore throat after general anesthesia and extubation of trachea intubation.Methods Sixty patients,aged from 18 to 60 years old,ASA I^II who underwent general anesthesia were sufferred from moderate to sever postoperative sore throat after extubation.The patients were randomly divided into two groups（30 cases in each）:inhalation group（group L）and internal branch of superior laryngeal nerve block group（group S）.Group L:100 mg of 2%lidocaine+1mg of budesonide suspension were prepared with normal saline and inhaled into10ml atomized inhalation（oxygen flow 8 L/min,mouth atomized inhalation for 15minutes）.Group S:ultrasound guided by 6¹3MHz high frequency linear probe,2%lidocaine（60 mg（3ml））was used to block the internal branches of bilateral superior laryngeal nerve（30mg,1.5ml）.VAS scores,laryngopharyngeal pain grading and analgesic significant effective rate were recorded for both groups immediately before treatment（T0）,10 min after treatment（T1）,30 min after treatment（T2）,1h（T3）,2 h（T4）,4h（T5）,8h（T6）,24h（T7）,and 48h（T8）.Record MAP,HR and SPO2 of T0^T8;After 30 minutes of treatment,50mg of flurbiprofen ester was given to patients with VAS≥4,and the total dosage was recorded within 48h.The VAS（visual analogue score）and the significant analgesic efficiency 10 min（T₁）,30 min（T₂）,1h（T₃）,2 h（T₄）,4h（T₅）,8 h（T₆）,24h（T₇）,and48h（T₈）after treatment.The MAP,HR and SPO₂ were also recorded at points of T₀^T₈.The adverse reactions such as postoperative chocking or aspiration,cough,hoarseness,dyspnea were observed in two groups.Results The VAS score and grade of POST in group S were significantly lower than that in group L at points T₁^T₆（P<0.01）,and the effective rate of analgesia in group S was significantly higher than that in group L atT₁^T₅（P<0.05）.HR of group S was lower than that of group L at points of T₁^T₂（P<0.05）,and MAP was lower than that of group L at points of T₁^T₃（P<0.05）.Satisfaction scores of group S were higher than that of group L（P<0.05）,1case（3%）of group S needed to intravenous Flurbiprofen Axetil Injection 50 mg,9 cases（30%）of group group L after treatment still needed to intravenous Flurbiprofen Axetil Injection 50 mg to relieve pain,1 case of group S appeared block throat numbness after 2 hours,1 case in sputum,two groups are not seen drinking water choke to cough,reflux aspiration,hoarseness,difficulty breathing,nausea,vomiting,etc.Conclusion Compared with local anesthetic inhalation,ultrasound-guided bilateral internal branch of superior laryngeal nerve blockade can effectively treat the postoperative sore throat after extubation under general anesthesia and provided an ideal treatment for POST in clinical work.