scholarly journals Comparative effectiveness of topical lignocaine nebulization and airway nerve blocks for awake fiber-optic nasal intubation in TM joint ankylosis

2021 ◽  
Vol 12 (12) ◽  
pp. 73-77
Author(s):  
Mohammad Sadiq Malla ◽  
Basharat Farooq ◽  
Rayees Najib ◽  
Sameena Ashraf
Keyword(s):  
Patient Satisfaction ◽  
Nerve Block ◽  
Fiber Optic ◽  
Laryngeal Nerve ◽  
Nasal Intubation ◽  
Nerve Blocks ◽  
Parametric Data ◽  
Group I ◽  
Group Ii ◽  
Joint Ankylosis

Background: Awake fiber-optic nasal intubation is a gold standard management of difficult airway in temporal mandibular (TM) joint ankylosis. Aims and Objectives: We compared topical lignocaine nebulization with airway nerve blocks for awake fiber-optic nasal intubation in TM joint ankylosis. Materials and Methods: Fifty patients of either gender were randomly allocated into two groups of 25 each. Group I received 10 ml of 2% lignocaine nebulization over a period for 20 min. Group II received bilateral superior laryngeal nerve block and transtracheal recurrent laryngeal nerve block (each with 2 ml of 2% lignocaine). Awake fiber-optic bronchoscopy-guided nasal intubation was done in all patients. All the patients received sedation during the procedure. The intubation time, intubating conditions, vocal cord position, cough severity, and degree of patient satisfaction were recorded. Student’s t-test was used to analyze parametric data, while the Mann–Whitney U-test was applied to non-parametric data and Fisher’s test to categorical data. P<0.05 was considered statistically significant. Results: The time taken for intubation was significantly shorter in Group II [110.2 (14.6) s compared with Group I (211.0 [22.3] s) (P=0.028 ss). The intubating conditions and degree of patient comfort were better in Group II compared with Group I. Although all patients were successfully intubated, patient satisfaction was higher in Group II. Conclusion: Airway nerve block is a better way of anesthetizing airway as compared to nebulization for awake fiber-optic nasal intubation. However, nebulization with lignocaine may be an alternative in situations where nerve blocks are not feasible or may be used as an adjuvant to nerve blocks.

scholarly journals Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in Peripheral Nerve Block - Three Prospective Randomized Controlled Studies

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
G M Nassif ◽  
B M E Noreldin ◽  
H M M Elazzazi ◽  
F A Abdelmalek ◽  
M M Maarouf
Keyword(s):  
Peripheral Nerve ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Group I ◽  
Group Ii ◽  
Long Acting

Abstract Introduction Peripheral nerve blocks are frequently used as the sole anesthetic technique or as an adjuvant to general anesthesia, However, the duration of sensory nerve block after single doses of long-acting local anesthetics is not consistent enough to avoid the use of postoperative opioids. Many adjuvants have been added to prolong the duration of nerve block, It was recently suggested that, based on current evidence, perineural dexmedetomidine is the most promising adjuvant to extend the duration of long-acting local anesthetics Aim The aim of this work is to study the effects of dexmedetomidine as an adjuvant to bupivacaine in various peripheral nerve blocks. The study will include: supraclavicular brachial plexus block, paravertebral block and femoral nerve block. Patients Adult patients of either sex aged 25 – 60 years, ASA physical status I and II, Elective surgeries appropriate for the nerve block. Methods patients received bupivacaine 0.5% alone in (group I) or bupivacaine 0.5% combined with 100 dexmedetomidine (group II) in peripheral nerve blocks. Motor and sensory block onset times; durations of blockades and analgesia were recorded Results Sensory and motor block onset times were shorter in group II than in group I. Sensory and motor blockade durations were longer in group II than in group I. Duration of analgesia was longer in group II than in group I. Systolic, diastolic arterial blood pressure levels, and heart rate were less in group II. Conclusion In the current study, it was obvious that:(Addition of dexmedetomidine to bupivacaine in supraclavicular nerve block, paravertebral nerve block and femoral nerve block has shortened the onset times of both sensory and motor blocks and significantly prolonged their durations, Dexmedetomidine had also the added effect of sedation with minimal side effects, which makes it a beneficial adjuvant to local anesthetics in peripheral nerve blocks, Addition of dexmedetomidine to bupivacaine prolonged the postoperative analgesia with subsequent consumption of less amount of analgesics and The use of ultrasonography in performing nerve blocks significantly reduced the incidence of complications such as pneumothorax or intra-arterial injection and hence, lowered the incidence of systemic toxicity of local anesthetics).

scholarly journals Upper Airway Nerve Block for Rigid Bronchoscopy in the Patients with Tracheal Stenosis: A Case Serie

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Parviz Amri ◽  
Novin Nikbakhsh ◽  
Seyed Reza Modaress ◽  
Ramin Nosrati
Keyword(s):  
Respiratory Distress ◽  
Nerve Block ◽  
Tracheal Stenosis ◽  
Superior Laryngeal Nerve ◽  
Upper Airway ◽  
Rigid Bronchoscopy ◽  
Laryngeal Nerve ◽  
Intravenous Sedation ◽  
Nerve Blocks

Background: Rigid bronchoscopy is often used to diagnose and treat the location of resection of the tracheal stenosis. It is a selective procedure for the dilatation of tracheal stenosis, especially when accompanied by respiratory distress. Objectives: We introduced patients who were diagnosed with tracheal stenosis and candidate for rigid bronchoscopy dilatation by the upper airway nerve blocks. Methods: This prospective observational study was conducted on 17 patients who underwent dilatation with rigid bronchoscopy in tracheal stenosis at Hospitals affiliated with Babol University of Medical Sciences from 2002 to 2017. The patients were given three nerve blocks, 6 bilateral superior laryngeal nerve block, bilateral glossopharyngeal nerve block, and recurrent laryngeal nerve block (transtracheal) before awake rigid bronchoscopy using 2% lidocaine. We evaluated the demographic data, the cause of tracheal stenosis, the quality of the airway nerve block (Intubation score), patients’ satisfaction from bronchoscopy and thoracic surgeons’ satisfaction. Complications of nerve blocks were recorded. Results: From 2002 to 2017, 17 patients (14 were male and 3 were) female with tracheal stenosis who were candidates for dilatation with bronchoscopy and accepted the upper nerve block were included. The quality of the block was acceptable in 16 (94%) patients. 15 patients received fentanyl, and only two patients did not need to intravenous sedation. The mean age of patients was 29.59 ± 11.59. The average satisfaction of the surgeon was 8.82 ± 1.13 and the satisfaction of patients with anesthesia was 8.89 ± 1.16. There was one serious complication (laryngospasm) in one patient. Conclusions: The upper airway nerve block method is a suitable anesthesia technique for patients with tracheal stenosis who are candidates for the tracheal dilatation with rigid bronoscopy, especially when the patient has respiratory distress and has not been evaluated before surgery.

scholarly journals Assessment of Relation between External Branch of Superior Laryngeal Nerve & Thyroid Gland- A Cadaveric Study

2020 ◽  
Vol 6 (2) ◽  
pp. 73-76
Author(s):  
Anurag ◽  
Vishnu Gupta
Keyword(s):  
Thyroid Gland ◽  
Cricoid Cartilage ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
The Body ◽  
Superior Thyroid Artery ◽  
Group I ◽  
External Branch ◽  
The Mean ◽  
Group Ii

Background: The thyroid gland is essential for normal growth of the body. This study assessed relation of external branch of superior laryngeal nerve to the superior pole of the thyroid gland. Subjects and Methods: This study was conducted on 25 human cadavers having 50 superior thyroid poles of both genders. Cadavers were classified based on age groups, group I was those with age less than 39 years and group II cadavers were those with age more than 40 years of age. Various measurements were performed on cadavers. Results: 14 cadavers were I group I and 11 were in group II. The mean mass was 67.2 Kgs in group I and 59.5 Kgs in group II, time elapsed after death was 481.5 minutes in group I and 476.4 minutes in group II, mean height was 1.74 meters in group I and 1.69 meters in group II, mean BMI found to be 22.3 kg/m2in group I and 20.1 kg/m2in group II. Height found to be significant between both groups (P< 0.05). The mean distance from EBSLN to cranial point of the thyroid gland was 6.66 mm in group I and 8.96 mm in group II. The mean transverse distance from superior thyroid artery to EBSLN was 3.55 mm in group I and 5.12 mm side in group II. The mean distance of the crossing point between the most cranial point of the thyroid lobe was 6.40 mm in group I and 11.47 mm in group II. The mean distance from the EBSLN to the midline of the neck was 19.80 mm in group I and 18.58 mm in group II. The mean distance from the EBSLN to the midline of the neck on the most cranial point of the cricoid cartilage was 18.77 mm in group I and 17.80 mm in group II. Conclusion: Authors found variation in measurements in left and right side in both group I and group II.

scholarly journals Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241834
Author(s):  
Li Zhipeng ◽  
He Meiyi ◽  
Wang Meirong ◽  
Jiang Qunmeng ◽  
Jia Zhenhua ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Sore Throat ◽  
Nerve Block ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Secondary Outcome ◽  
Ultrasound Guided ◽  
Postoperative Sore Throat ◽  
Internal Branch ◽  
Group I

Introduction Ultrasound-guided internal branch of the upper laryngeal nerve block (USG-guided iSLN block) have been used to decrease the perioperative stress response of intubation. It is more likely to be successful than blindly administered superior laryngeal nerve blocks with fewer complications. Here, we evaluated the efficacy of USG-guided iSLN block to treat postoperative sore throat (postoperative sore throat, POST) after extubation. Methods 100 patients, aged from 18 to 60 years old, ASA I~II who underwent general anesthesia and suffered from the moderate to severe postoperative sore throat after extubation were randomized into two groups(50 cases per group). Patients in group S received USG-guided iSLN block bilaterally (60mg of 2% lidocaine, 1.5ml each side), whereas those in group I received inhalation with 100 mg of 2% lidocaine and 1mg of budesonide suspension diluted with normal saline (oxygen flow 8 L /min, inhalation for 15 minutes). The primary outcome were VAS scores in both groups before treatment (T0), 10 min (T1), 30 min(T2), 1h(T3), 2 h(T4), 4h(T5), 8h(T6), 24h(T7), and 48h(T8) after treatment. The secondary outcome were satisfaction scores after treatment, MAP, HR, and SPO2 fromT0 to T8. The adverse reactions such as postoperative chocking or aspiration, cough, hoarseness, dyspnea were also observed in both groups. Results Patients in group S had significantly lower VAS score than that in group I at points of T1 ~ T6 (P < 0.01). HR of group S was lower than that of group I at points of T1 ~ T2and T4 (P < 0.05), and MAP was lower than that of group I at points of T1 ~ T3 (P < 0.05). Satisfaction scores of group S were higher than that of group I (P <0.05), In group S, 2 case (4%) needed to intravenous Flurbiprofen Injection 50 mg to relieve pain; in group I, 13 cases (26%) received Flurbiprofen Injection. 2 case of group S appeared throat numbness after treatment for 3 hours; 2 patients have difficult in expectoration after treatment recovered after 3hour. No serious adverse events were observed in both groups. Conclusion Compared with inhalation, USG-guided iSLN block may effectively relieve the postoperative sore throat after extubation under general anesthesia and provided an ideal treatment for POST in clinical work.

scholarly journals Ideal Anatomic Location for Saphenous Nerve Block for Foot and Ankle Surgeries: A Prospective Randomized Clinical Evaluation

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Karl Henrikson ◽  
Sanjib Adhikary ◽  
Gregory Pace ◽  
Wai Liu ◽  
Paul Juliano ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Score ◽  
Nerve Block ◽  
Knee Extension ◽  
Saphenous Nerve ◽  
Foot And Ankle ◽  
Nerve Blocks ◽  
Knee Extension Strength ◽  
Significant Difference ◽  
Isometric Knee Extension

Category: Regional anesthesia for foot and ankle surgery Introduction/Purpose: Regional anesthesia has resulted in significant improvements in patient outcomes including reduced postoperative pain, opioid consumption, opioid-related adverse effects, and decreased postoperative length of stay. Saphenous nerve blocks provide distal analgesia while minimizing the reduction in quadriceps strength seen with more proximal femoral nerve blocks. Saphenous nerve blocks may be performed at the mid-thigh with the subsartorial technique or just proximal to the knee with the transsartorial technique. The present study compares these two techniques in terms of analgesia effectiveness and quadriceps motor preservation. Methods: This study was approved by our institutional IRB committee. A power analysis was conducted prior to the study. Patients, aged 18 to 65, were prospectively identified from a list of elective foot and ankle surgeries performed by one of the study investigators. Preoperatively, bilateral isometric knee extension strength was measured, and subjects completed a PROMIS global health survey. The surgeon was blinded to the randomization of patients to proximal or distal blocks. Bilateral isometric knee extension strength was reassessed following the block as well as sensation, post-operative visual analogue pain score (VAS), and subjective satisfaction. Due to non-normality of the sample, the Wilcoxon rank-sum test was employed to analyze continuous variables such as strength measures. For categorical variables such as gender, pain score, and patient satisfaction, the Pearson chi- square test was used. Results: Twenty-four patients (24 lower extremities) were enrolled in the study and 12 randomized to each group. The two groups were not significantly different in age, gender, or pre-operative PROMIS Mental and Physical Summary Scores. The nerve block procedure was successfully performed in a single attempt in all cases. The VAS was not significantly different at 2 in the distal group and 3 in the proximal group. In each group 11 patients were totally satisfied with the block and 1 was moderately satisfied. The knee extension strength decreased in both the operative and non-operative lower extremity following administration of the nerve block. When normalized to the effect in the non-operative extremity, there was no significant difference in strength decrease between the two groups (p=0.89). Conclusion: This randomized, single-blinded trial compared proximal subsartorial saphenous nerve block with distal transsartorial saphenous nerve block outside of the adductor canal. There was no significant difference in the efficacy of the two techniques was observed in terms of VAS pain score or patient satisfaction and no difference in post-operative weakness. This is the first randomized trial on saphenous nerve blocks to normalize strength to the non-operative lower extremity, reducing the confounding effect of peri-operative narcotic and sedative medications. This study offers evidence for equivalence of the subsartorial and transsartorial saphenous nerve block techniques.

Surgical Treatment of Moderate Hallux Valgus: A Comparison of Distal Chevron Metatarsal Osteotomy With and Without Lateral Soft-Tissue Release

2017 ◽  
Vol 10 (6) ◽  
pp. 524-530 ◽  
Author(s):  
Maki Grle ◽  
Goran Vrgoc ◽  
Ivan Bohacek ◽  
Vladimir Hohnjec ◽  
Marko Martinac ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Hallux Valgus ◽  
Soft Tissue Release ◽  
Metatarsal Osteotomy ◽  
Group I ◽  
Group Ii ◽  
Surgical Treatments

Purpose: The purpose of the study was to determine whether lateral soft-tissue release (LSTR) has a beneficial or detrimental effect on the outcome of distal Chevron first metatarsal osteotomy (DCMO) in the treatment of moderate hallux valgus (HV). Methods: We compared the effect of different surgical treatments in 2 groups of patients: group I (23 patients, 25 feet, average age of 55 [from 43 to 77] years) was subjected to DCMO only, whereas group II (18 patients, 23 feet, average age of 59 [from 52 to 70] years]) was subjected to DCMO with LSTR. The American Orthopaedic Foot and Ankle Society’s Hallux Metatarsophalangeal-Interphalangeal scale survey was conducted postoperatively, followed by the brief survey on postoperative patient satisfaction. The patient follow-up period was from 18 to 24 months after surgical treatment, on average. Results: After surgical intervention, both groups of patients presented with an improved HV angle, but there was no significant difference between the groups. However, group II showed significant improvements in medial sesamoid bone position and patient satisfaction scores as compared with group I. Conclusion: Our midterm follow-up of surgical treatments for moderate HV deformity suggests that both procedures provide good postoperative results. However, according to our results, DCMO with LSTR provides better results than procedures without LSTR. Levels of Evidence: Therapeutic, Level III: Retrospective comparative study

scholarly journals Comparative Study between Adductor Canal Block, Femoral Nerve Block and Epidural Analgesia for Management of Post-Operative Pain in Total Knee Replacement

2021 ◽  
pp. 177-188
Author(s):  
Heba Salah Eldin Ismail Gawish ◽  
Amr Arafa Mohammed Elbadry ◽  
Nagat Sayed Mohammed El-Shmaa ◽  
Abdelraheem Mostafa Dowidar
Keyword(s):  
Postoperative Pain ◽  
Nerve Block ◽  
Femoral Nerve ◽  
Group Iii ◽  
Insignificant Change ◽  
Adductor Canal ◽  
Arterial Blood ◽  
Group I ◽  
Total Knee ◽  
Group Ii

Background: Total knee arthroplasty (TKA) is a common surgery that is associated with moderate to severe pain. Early ambulation and physical therapy are essential for functional recovery and long-term functional outcome after TKA as well as for reducing the immobility related complications. Hence, optimal pain relief while maintaining the motor function remains the mainstay in postoperative pain management after TKA. ‎Patients and Methods: This prospective randomized controlled open-labelled study was carried out at Tanta University Hospital, Orthopedic Surgery Department from January 2020 to February 2021. Results: Heart rate was significantly increased at 12 and 18 hours postoperatively in group I and II compared to group III and there was insignificant change between group I and group II. Mean arterial blood pressure was significantly increased at 12 and 18 hours postoperatively in group I and II compared to group III and was insignificant change between group I and group II.NRS was significantly increased at 12 and 18 hours postoperatively in group I and II compared to group III and was insignificant change between group I and group II. Patient satisfaction was significantly higher in group III compared to group I and group II on the second postoperative day. Conclusion: Adductor canal nerve block provide better postoperative pain relieve with lower NRS after TKA than femoral and epidural blocks. It provides more stability of hemodynamic parameter and longer time for the 1st time of analgesic request. Also, total consumption of morphine in 1st postoperative day is lower than femoral and epidural blocks.

Preparation for Advanced Airway Management: Preparation for Awake Intubation

2019 ◽  
Author(s):  
Arpan Mehta ◽  
Adrian Pichurko
Keyword(s):  
Nerve Block ◽  
Local Anesthetic ◽  
Superior Laryngeal Nerve ◽  
Management Plan ◽  
Laryngeal Nerve ◽  
Awake Intubation ◽  
Nerve Blocks ◽  
Local Anesthetic Toxicity ◽  
Safe Management ◽  
Management Preparation

Awake intubation is a key technique in anesthesia, allowing for the safe management of a patient with signs and predictors of a difficult airway/intubation. It is commonly undertaken electively, but can also be used in an emergency. An appropriate history must be taken, along with review of investigations (e.g CT scan, nasendoscopy), followed by a physical examination and development of a safe management plan. A variety of local anesthetic methods exist for topicalization of the airway (2-4% lidocaine), including nerve blocks (glossopharyngeal, recurrent laryngeal, superior laryngeal) to assist this. Sedation and amnesic techniques commonly include the use of benzodiazepines (midazolam), opioids (remifentanil infusion) and alpha agonists (dexmedetomidine). Knowledge of the side effects of these are paramount, including the cardiac and central nervous system with local anesthetic toxicity. 20% lipid emulsions are available in the event of this. This review contains 4 figures, 5 tables, and 25 references. Keywords: awake flexible bronchoscopic intubation, awake endoscopic intubation, remifentanil, dexmedetomidine, airway anesthesia, glossopharyngeal nerve block, recurrent laryngeal nerve block, superior laryngeal nerve block, local anesthetic toxicity, lipid emulation.

Delayed Resolution of Residual Hemifacial Spasm after Microvascular Decompression Operations

Neurosurgery ◽  
2001 ◽  
Vol 49 (4) ◽  
pp. 847-856 ◽  
Author(s):  
Mami Ishikawa ◽  
Toru Nakanishi ◽  
Yoshiaki Takamiya ◽  
Jun Namiki
Keyword(s):  
Regression Analysis ◽  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Proportional Hazards ◽  
Silent Period ◽  
Cox Proportional Hazards ◽  
Nerve Blocks ◽  
Group I ◽  
Group Ii

Abstract OBJECTIVE After microvascular decompression to treat hemifacial spasm (HFS), resolution of the HFS is often gradual. We carefully investigated the course of the gradual resolution of HFS and examined the differences between patients with and without postoperative HFS. METHODS One hundred seventy-five patients with HFS were monitored, for observation of 1) whether postoperative HFS occurred, 2) when it occurred, and 3) when it disappeared after microvascular decompression. For two groups of patients, with (Group I) and without (Group II) postoperative HFS, we investigated age, sex, spasm side, preoperative facial nerve block (botulinum toxin treatment), decompression material, preoperative HFS period, offender (compressing vessel), temporary and permanent postoperative complications, and electromyographic findings. RESULTS In Group I (88 patients), postoperative HFS began within 4 days after surgery, a period that we have termed the silent period of postoperative HFS; the median value for the time to resolution was 28 days. The other 87 patients exhibited no postoperative HFS (Group II). There was a significantly higher incidence of postoperative facial weakness in Group II (Group II, 41.3%; Group I, 25.5%;P = 0.02 by logistic regression analysis). In Group I, there was no statistically significant relationship between the investigated parameters and the silent period or the postoperative HFS period, as determined by Cox proportional-hazards regression analysis, except for the number of preoperative facial nerve blocks. Electromyographic investigation of F waves revealed facial paresis during the silent period in a patient. CONCLUSION Approximately 50% of patients with HFS exhibited residual spasm postoperatively. An immediate postoperative silent period of 4 days without spasm was characteristic. One-quarter, one-half, and 90% of the residual spasm resolved by 1 week, 1 month, and 8 months after surgery, respectively.

scholarly journals Anatomical Variation of Recurrent Laryngeal Nerve with Inferior Thyroid Artery: A Cross Sectional Study in Bangladeshi People

2021 ◽  
Vol 18 (1) ◽  
pp. 7-12
Author(s):  
Md Rabiul Islam ◽  
Tahmina Begum ◽  
Nazrul Islam ◽  
Md Moshabbirul Islam
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Anatomical Variation ◽  
Cross Sectional Study ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group I ◽  
Group Ii ◽  
The Right

Background: Recurrent laryngeal nerve is varied anatomically with inferior thyroid artery. Objective: The purpose of the present study was to observe the anatomical variation of recurrent laryngeal nerve with inferior thyroid artery among Bangladeshi people. Methodology: This comparative cross-sectional study was conducted in the Department of Otolaryngology and Head-Neck surgery at Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh from January 2004 to December 2004 for a period of one (01) year. Patients whose recurrent laryngeal nerve was identified during thyroidectomy due to various pathological conditions of thyroid gland were selected as group I. Again, the dead body which were undergone dissection were designated as group II. All the patients whose recurrent laryngeal nerve and inferior thyroid artery were identified during total, near total, sub-total, hemithyroidectomised or lobectomised were included in this study. Result: A total number of 32 patients were recruited for this study. On the left side nerve was found anteriorly in 2(10.53%), in between in 4(21.05%) and posteriorly in 13(68.42%). On the right side-nerve was found anteriorly in 7(30.43%), in between in 6(26.09%) and posteriorly in 10(43.48%). In this series nerve was seen posterior relation more than other two relations and anterior relation more on right side whereas posterior relation on left side, anterior relation more than in between relation on right side but reverse on left side. In group II On the left side nerve was found anteriorly in 2(6.25%), in between in 6(18.75%) and posteriorly in 24(75%). On the right side-nerve was found anteriorly in 8(25%), in between in 9(28.12%), and posteriorly in 10(46.88%). Conclusion: In conclusion each recurrent laryngeal nerve lies posterior to the inferior thyroid artery in the majority of the occasions whereas the nerve lies anterior to the branches of the inferior thyroid artery less commonly except right side of both study group. Journal of Science Foundation, January 2020;18(1):7-12

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