General Anesthesia
Efficacy of airway topical anesthesia with combination of superior laryngeal nerve block and thyrocricoid membrane puncture for tracheal intubation in pediatric patients with Pierre Robin Sequence
Hongwei Wang, Chenhui He, Lanlan Li, Long He, Wei Zhang, Yanqiu Ai, Jianjun Yang, Wei He
Published 2018-09-20
Cite as Chin J Anesthesiol, 2018, 38(9): 1111-1113. DOI: 10.3760/cma.j.issn.0254-1416.2018.09.022
Abstract
ObjectiveTo evaluate the efficacy of airway topical anesthesia with combination of superior laryngeal nerve block (SLNB) and thyrocricoid membrane puncture for tracheal intubation in the pediatric patients with Pierre Robin Sequence.
MethodsThirty-two American Society of Anesthesiologist physical status Ⅰ or Ⅱ pediatric patients with Pierre Robin Sequence, aged 5-12 months, weighing 5-13 kg, scheduled for elective cleft palate repair under general anesthesia, were divided into 2 groups (n=16 each) using a random number table method: control group (group C) and airway topical anesthesia with SLNB-thyrocricoid membrane puncture group (group ST). After anesthesia was induced by inhaling sevoflurane by mask on admission to the operating room, 2% lidocaine 0.5 ml was injected around the bilateral superior laryngeal nerve under ultrasound guidance, and then 2% lidocaine 1 ml was injected via the thyrocricoid membrane in group ST, and the root of tongue, pharynx and larynx were sprayed with 2% lidocaine by using a laryngotracheal mucosal atomization device in group C. The pediatric patients were tracheally intubated guided by a video laryngoscope 3 min later.The development of cardiovascular responses, vocal cord activity and body movement was recorded during intubation.The intubation time, success rate of intubation at first attempt and patient′s tolerance to tube were recorded.The occurrence of postoperative hoarseness was also recorded.
ResultsCompared with group C, the incidence of cardiovascular responses, vocal cord activity and body movement was significantly decreased, the intubation time was shortened, the success rate of intubation at first attempt was increased, and the patient′s tolerance to tube score was decreased in group ST (P<0.05).
ConclusionAirway topical anesthesia with combination of SLNB and thyrocricoid membrane puncture can provide better intubation conditions when used for the pediatric patients with Pierre Robin Sequence.
Key words:
Nerve block; Anesthesia, local; Intubation, intratracheal; Pierre Robin Syndrome
Contributor Information
Hongwei Wang
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Chenhui He
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Lanlan Li
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Long He
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Wei Zhang
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Yanqiu Ai
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Jianjun Yang
Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Wei He
Department of Stomatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China