Indian journal of anaesthesia · 2026
Effect of ultrasound-guided superior laryngeal nerve block on intubation-induced haemodynamic changes in hypertensive patients: A randomised clinical trial.
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Sen Krishnendu, Varma Prerna, Jangra Kiran, Jafra Anudeep, Jain Divya
Аннотация
BACKGROUND AND AIMS: Laryngoscopy and endotracheal intubation are associated with a sympathetic response which is detrimental in hypertensive patients. Blocking afferent laryngeal reflexes with the internal branch of the superior laryngeal nerve block (iSLNB) may attenuate this response. This study aimed to evaluate the effectiveness of ultrasound-guided bilateral iSLNB as an adjunct to general anaesthesia (GA) in blunting the haemodynamic response to intubation in patients with hypertension.
METHODS: This prospective, randomised, single-blind clinical trial enroled adult patients with hypertension undergoing elective non-airway surgery under GA with tracheal intubation. Participants were randomly allocated to two groups. The iSLNB group received ultrasound-guided bilateral iSLNB using lignocaine following intravenous induction, while the control group received standard intravenous induction. The primary outcome was change in mean blood pressure (∆MBP) from pre-intubation to one-minute post-intubation. Secondary outcomes included change in systolic and diastolic blood pressure, heart rate at predefined intervals, incidence and severity of postoperative sore throat, and procedure-related adverse events.
RESULTS: A total of 50 patients were analysed, 25 in each group. The change in post-intubation MBP at one minute was significantly lower in the iSLNB group compared to the control group (mean difference 6.2 mm Hg; 95% confidence interval 0.73-11.67; P = 0.03), while changes in heart rate were comparable during the study period. The postoperative sore throat was significantly lower in the iSLNB group (P = 0.01), and no block-related adverse events were observed.
CONCLUSION: Ultrasound-guided iSLNB as an adjunct to GA effectively attenuates the haemodynamic response to endotracheal intubation.
METHODS: This prospective, randomised, single-blind clinical trial enroled adult patients with hypertension undergoing elective non-airway surgery under GA with tracheal intubation. Participants were randomly allocated to two groups. The iSLNB group received ultrasound-guided bilateral iSLNB using lignocaine following intravenous induction, while the control group received standard intravenous induction. The primary outcome was change in mean blood pressure (∆MBP) from pre-intubation to one-minute post-intubation. Secondary outcomes included change in systolic and diastolic blood pressure, heart rate at predefined intervals, incidence and severity of postoperative sore throat, and procedure-related adverse events.
RESULTS: A total of 50 patients were analysed, 25 in each group. The change in post-intubation MBP at one minute was significantly lower in the iSLNB group compared to the control group (mean difference 6.2 mm Hg; 95% confidence interval 0.73-11.67; P = 0.03), while changes in heart rate were comparable during the study period. The postoperative sore throat was significantly lower in the iSLNB group (P = 0.01), and no block-related adverse events were observed.
CONCLUSION: Ultrasound-guided iSLNB as an adjunct to GA effectively attenuates the haemodynamic response to endotracheal intubation.