Ultrasound-guided bilateral internal laryngeal nerve block for suppression of postoperative cough in adults undergoing endoscopic microlaryngeal laser surgeries: A randomized controlled trial.

Background and Aims: The incidence of postoperative cough in patients undergoing endoscopic laryngeal surgery is 86%. This study aims to evaluate the efficacy of ultrasound-guided bilateral internal laryngeal nerve block as an adjunct to general anesthesia in reducing the incidence and severity of postoperative cough, sore throat, and hoarseness of voice, as well as managing the perioperative hemodynamic changes in endoscopic microlaryngeal laser surgery (MLS). Material and Methods: Forty patients aged 18-65 years scheduled to undergo endoscopic MLS under general anesthesia were recruited into the study. Patients were randomized into two groups of 20 patients in each group. Patients in group I received ultrasound-guided internal laryngeal nerve block bilaterally with 2.5 ml of 2% lignocaine on either side along with general anesthesia, whereas those in group II received only general anesthesia. Results: At the time of emergence, only 35% of patients in group I had mild cough; however, in Group II, 60% patients had mild cough, 25% had moderate cough, and 5% had severe cough. The differences between the two groups were statistically significant ( Conclusions: Bilateral internal laryngeal nerve block as an adjunct to general anesthesia significantly reduces the incidence and severity of cough at the time of emergence from anesthesia in MLS. However, no significant reduction in the incidence and severity of sore throat was detected.