Effect of intracordal injection under local anesthesia on vital signs in high-risk patients

Tomohiro Hasegawa; Takeharu Kanazawa; Daigo Komazawa; Ujimoto Konomi; Mayu Hirosaki; Makoto Ito; Hiroshi Nishino; Yusuke Watanabe

doi:10.1016/j.anl.2021.09.002

Effect of intracordal injection under local anesthesia on vital signs in high-risk patients

Auris Nasus Larynx. 2022 Jun;49(3):445-453. doi: 10.1016/j.anl.2021.09.002. Epub 2021 Oct 26.

Authors

Tomohiro Hasegawa¹, Takeharu Kanazawa², Daigo Komazawa³, Ujimoto Konomi⁴, Mayu Hirosaki⁵, Makoto Ito², Hiroshi Nishino², Yusuke Watanabe⁶

Affiliations

¹ Tokyo Voice Center,International University of Health and Welfare, Tokyo, Japan. Electronic address: t-hasegawa1@iuhw.ac.jp.
² Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, Tochigi, Japan.
³ AKASAKA Voice Health Center, Tokyo, Japan.
⁴ Voice and Dizziness Clinic Futakotamagawa Otolaryngology, Tokyo, Japan.
⁵ Tokyo Voice Center,International University of Health and Welfare, Tokyo, Japan.
⁶ Tokyo Voice Center,International University of Health and Welfare, Tokyo, Japan. Electronic address: nabe@iuhw.ac.jp.

PMID: 34711470
DOI: 10.1016/j.anl.2021.09.002

Abstract

Objective: Intracordal injection under local anesthesia is widely performed; however, few studies show hemodynamic changes in the heart rate, blood oxygen saturation, and blood pressure during intracordal injection under local anesthesia. This study examined changes in vital signs (heart rate, blood oxygen saturation, systolic blood pressure, diastolic blood pressure) during intracordal injection under local anesthesia among high-risk patients and investigated whether intracordal injection under local anesthesia could be safely conducted.

Methods: A retrospective chart review was adopted as the research design. We investigated the changes in vital signs (heart rate, blood oxygen saturation, blood pressure) before and after intracordal injection with basic fibroblast growth factor (bFGF) preparations under local anesthesia in 46 patients who visited our institution and developed unilateral vocal cord paralysis after a thoracic aortic aneurysm, thoracic aortic dissection surgery, thyroid disease, esophageal disease, idiopathic disease, etc. RESULTS: The average operation time for the high-risk group was 3.67 minutes, with the shortest operating time being 2 minutes and the maximum operating time being 13 minutes. The average operation time for the control group was 3.73 minutes, with the shortest operating time being 1 minute and the maximum operating time being 9 minutes. Results before and after intracordal injection with bFGF preparations under local anesthesia for heart rate, blood oxygen saturation, systolic blood pressure, and diastolic blood pressure had P-values of 0.324, 0.394, 0.215, and 0.508, respectively, in the high-risk group, and no significant differences were found. Conversely, heart rate, blood oxygen saturation, systolic blood pressure, and diastolic blood pressure had P-values of 0.057, 0.232, 0.265, and 0.091, respectively, in the control group, and no significant differences were found.

Conclusion: Intracordal injection under local anesthesia may be safe, even for patients who require blood pressure management after thoracic aortic disease surgery.

Keywords: Basic fibroblast growth factor; Intracordal injection under local anesthesia; Metabolic equivalent of tasks; Vital changes; Vocal cord paralysis.

MeSH terms

Anesthesia, Local*
Humans
Injections
Retrospective Studies
Vital Signs
Vocal Cord Paralysis* / surgery