Comparison of Efficacy of Lignocaine Anesthesia of Vocal Cords by “spray as You Go” through a Bronchoscope with Lignocaine Injection through the Cricothyroid Membrane

Objective: To assess and compare the efficacy of lignocaine anesthesia of vocal cords by “spray as you go” through a bronchoscope with lignocaine injection through the cricothyroid membrane. Study Design: Quasi experimental study. Place and Duration of Study: This study was done in Combined Military Hospital Peshawar form May 2009 to June 2010. Material and Methods: Thirty patients in each group were given local anesthesia to the vocal cords. With lignocaine either via intratracheal instillation through the cricothyroid membrane or through a fibreoptic bronchoscope “spray as you go”. A cough score was calculated by recording the number of coughs as the bronchoscope was advanced through the cords into the trachea. A twenty point unpleasantness score was marked by the patient 2 hours after the procedure. Result: Cough score and unpleasantness score was compared among the two groups using SPSS version 19. Median unpleasantness score was 6 [Inter quartile range (IQR) 4-8] whereas median cough score was 2(IQR 0-3). The difference was statistically significant among the two groups for both cough and unpleasant scores (p < 0.001 and p < 0.001 respectively). Conclusion: Intratracheal injection of lignocaine is more comfortable for the patient. It induces much less cough and irritability to the patient than the “spray as you go” technique.