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Objective: To compare the effectiveness of trans-tracheal block alone versus bilateral superior laryngeal and trans-tracheal block in terms of occurrence of cough and gag reflex during awake fiberoptic intubation. Study Design: Randomized controlled clinical trial Place and Duration: Department of Anesthesia, Combined Military Hospital Rawalpindi over 10 month’s from1 st Sep 2017- 30th June 2018. Methodology: After randomly selecting 60 patients with anticipated difficult airway for awake fiberoptic intubation, patients were divided into two groups (T and S) with 30pts each group. Group T were given only trans-tracheal block with 2%lignocaine 2ml; whereas patients in Group S were given bilateral superior laryngeal 2% lignocaine 1 ml each side along with trans-tracheal block. Our outcomes were: presence of cough, gag reflex and patient comfort. Results: Out of 60 patients, in Group T, 10% patients had cough versus 7% patients in Group S (p value=0.640) during awake intubation. Similarly 7% patients in group T and 10% in group S had gag reflex (p-value=0.640). 83% patients in group T were comfortable with procedure and only 60% in group S (p-value=0.045). Conclusion: Trans-tracheal block alone is as effective as combination of bilateral superior laryngeal blocks with trans-tracheal block in terms of occurrence of cough or gag reflex during awake fiberoptic intubation.

Fariha Ahmad, Naseem Ahmed, Mohammed Yasrab, Saira Mehboob, Hamid Shah, Tassadaq Khurshid. (2019) Comparison between effectiveness of transtracheal block alone versus superior laryngeal nerve block and transtracheal block for awake fiberoptic intubation: A randomized controlled trial., Isra Medical Journal, Volume 11, Issue 2.
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