Does the Use of Topical Lignocaine Spray during Microlaryngeal Surgery Under General Anaesthesia have Significant Clinical Benefit? - A Prospective Double-Blind Randomized Placebo-Controlled TrialMontague ML1*, Vernham GA1, Todd G2 and MacKenzie K1
1Department of Otolaryngology and Head and Neck Surgery, UK
2Department of Anaesthetics, North Glasgow University Hospitals NHS Trust, Glasgow, UK
- *Corresponding Author:
- Mary-Louise Montague
University Department of Otolaryngology
The Royal Hospital for Sick Children 9 Sciennes Road
Edinburgh, EH9 1LF United Kindom
Tel: +44 (0) 131 536 0830
E-mail: [email protected]
Received date: March 01, 2014; Accepted date: September 19, 2014; Published date: September 29, 2014
Citation: Montague ML, Vernham GA, Todd G, MacKenzie K (2014) Does the Use of Topical Lignocaine Spray during Microlaryngeal Surgery Under General Anaesthesia have Significant Clinical Benefit? - A Prospective Double-Blind Randomized Placebo-Controlled Trial. J Anesth Clin Res 5:436. doi: 10.4172/2155-6148.1000436
Copyright: 2014 Montague ML, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To determine if topical lignocaine used during microlaryngeal surgery under general anaesthesia confers significant clinical benefit by reducing the pressor response and laryngospasm that often occur during recovery.
Study Design: Prospective double-blind randomised placebo-controlled trial in a UK Otolaryngology department. 85 patients undergoing elective microlaryngeal surgery receiving either 4 ml 4% lignocaine spray to the vocal cords and piriform fossae or 4 ml 0.9% saline spray to the same areas at induction of anaesthesia.
Methods: Primary outcome measures were pulse and blood pressure recorded immediately before spray application and at 5 minute intervals during recovery for 20 minutes and the degree of laryngospasm or cough (absent, mild, moderate, severe) recorded at the same intervals. Secondary outcome measures included patient grading of post-operative throat discomfort on a visual analogue scale (1 to 100 mm) and analgesia requirements in the first 6 hours post-operatively.
Results: 44 patients (mean age 58 years, 22 male, 22 female) were randomised to receive lignocaine and 41 patients (mean age 57 years, 24 male, 17 female) saline spray. No statistically significant difference was found between groups in mean pulse or mean systolic and diastolic blood pressure immediately before application of spray or during the recovery period. There was no difference in the degree of post-operative coughing or laryngospasm or analgesia requirements between the groups. Topical lignocaine was associated with more throat discomfort than saline (p=0.03; Diff 0.9; 95% C.I. 0.1 to 1.8).
Conclusion: The use of topical lignocaine spray conferred no clinical benefit in this study.