The effect of ultrasound-guided bilateral superior laryngeal nerve block on the prognosis of cervical fracture surgery

Cervical spine fractures present unique anesthetic challenges due to cervical instability and proximity to critical structures. This study evaluated the effects of ultrasound-guided bilateral superior laryngeal nerve block on postoperative outcomes in cervical spine fracture surgery. This retrospective study analyzed 99 patients with cervical spine fractures (C3-C7) undergoing surgery between January 2021 and December 2023. Patients were divided into control group (n=46) receiving standard general anesthesia and intervention group (n=53) receiving additional ultrasound-guided bilateral superior laryngeal nerve block with 0.5% ropivacaine. Primary outcome was postoperative pain intensity (VAS scores). Secondary outcomes included opioid consumption, neurological recovery (ASIA, JOA scores), functional outcomes (NDI), and quality of life measures. The intervention group demonstrated significantly lower VAS pain scores at all time points (p < 0.001), with 38.6% reduction in morphine consumption (32.4 ± 18.6 vs. 52.8 ± 24.3 mg, p < 0.001). At 3 months, neurological recovery was superior with 47.2% showing ASIA grade improvement versus 28.3% in controls (p = 0.049). JOA score improvements were greater (5.4 ± 2.8 vs. 3.7 ± 2.5, p = 0.002), and NDI scores indicated reduced disability (28.6 ± 12.4 vs. 36.2 ± 14.8, p = 0.004). Hospital stays were shorter (7.2 ± 2.8 vs. 9.4 ± 3.6 days, p = 0.001), and return to activity was faster (62.3% vs. 43.5% at 3 months, p = 0.049). Only minor complications occurred (3.8% temporary hoarseness), with no serious adverse events. Ultrasound-guided bilateral superior laryngeal nerve block significantly improves postoperative outcomes in cervical spine fracture surgery, providing superior pain control, enhanced neurological recovery, and better functional outcomes with excellent safety. This technique should be integrated into standard anesthetic protocols for cervical spine fracture surgery.