Comparison of airway blocks versus general anaesthesia for diagnostic direct laryngoscopy: A randomised comparative trial

Background and Objective: Direct rigid laryngoscopy and general anaesthesia (GA) are associated with many problems. Regional anaesthesia/airway blocks can be considered as safer and easier alternative techniques especially among old and comorbid patients and conditions with difficult airways as well. The present study was conducted to compare efficacy of regional anaesthesia/airway blocks versus general anaesthesia for diagnostic direct (rigid) laryngoscopy. Methods: A randomised comparative trial was conducted among patients undergoing diagnostic direct laryngoscopy (DLS) for perilaryngeal lesions. Eighty patients of either sex aged between 20and 80 years and categorised as American Society of Anesthesiologists(ASA) grade I, II, III or IV were divided under two groups of 40 patients each. Group-A underwent DLS with airway blocks and group-B underwent DLS under GA. Haemodynamic parameters and analgesia were interpreted statistically. Results: Difference in haemodynamic stability and quality of post- operative analgesia were primary outcomes. Patients in group-A were observed to be haemodynamically more stable as compared to group-B patients with statistically significant P value (0.003 and 0.016 for pulse rate at 6 min and mean arterial pressure at 4 min, respectively). In postoperative period, group-A patients were found to be more comfortable (lower VAS scores) than group-B patients with P value (0.040, 0.043, 0.044 at 0, 5, 15 min, respectively). Conclusion: Regional airway blocks provide better haemodynamic stability and postoperative analgesia than general anaesthesia.