Sonographically Guided Superior Laryngeal Nerve Block During Awake Fiberoptic Intubation

Abstract

We report 5 patients who underwent ultrasound-guided superior laryngeal nerve block before awake intubation and general anesthesia. We used a 8- to 15-MHz hockey stick-shaped ultrasound transducer (HST15-8/20 linear probe, Ultrasonix) to visualize the superior laryngeal nerve. A 3.8-cm 25-G needle was inserted in real time and directed toward the superior laryngeal nerve followed by circumferential placement of local anesthetic. All 5 patients tolerated subsequent awake fiberoptic intubation with either minimal or no sedation. Sonographically guided superior laryngeal nerve block may be useful in patients where identification of landmarks in the neck is difficult as a result of patient anatomy.

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

“…Blocking the internal branch of the superior laryngeal nerve (iSLN) can achieve the anesthetic effect of the root of tongue, epiglottis, and laryngeal mucosa above glottis fissure [6]. Several studies have also shown that the blockade of the internal branch of the superior laryngeal nerve can be used during fiberoptic bronchoscopy, laryngoscopic surgery, conscious intubation of difficult airway to reduce the hemodynamic change caused by airway stimulation and provide better practical condition for operation [7][8][9]. Although others have reported bilateral iSLN block may reduce the severity of POST in assisted laryngoscopic surgery, we are not aware of any high quality randomized, controlled trials that have investigated the effectiveness of ultrasound guided internal branch of superior laryngeal nerve block (USG-guided iSLN block) on pcostoperative sore throat as compared with atomization inhalation, as treatment for POST.…”

Comparison of ultrasound and anatomical landmark-guided technique for superior laryngeal nerve block to aid awake fibre-optic intubation: A prospective randomised clinical study

“…The use of hockey stick-shaped transducer for ibSLN block has been reported to provide better space for administration of block without compromising the image. [15]…”

Front of neck: continued discovery of this anatomy essential for airway management

“…It is normally easily identified by palpation of the cornu of the hyoid bone, but ultrasonography can help identify the anatomy. 17 The cricotracheal membrane ('cricotracheal ligament') is the interspace between the lower border of the cricoid cartilage and the upper border of the first tracheal ring (Fig. 1).…”