Pregledni rad
https://doi.org/10.20471/acc.2016.55.s1.12
Upper Airway Blocks for Awake Difficult Airway Management
Tatjana Stopar Pintarič
; Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre and Institute of Anatomy, Medical Faculty, Ljubljana, Slovenia
Sažetak
Airway anesthesia is pivotal for successful awake intubation provided either topically or by blocks. Airway blocks are considered technically more difficult to perform and carry a higher risk of complications. However, in experienced hands, they can be useful as they provide excellent intubating conditions. For complete upper airway anesthesia, bilateral glossopharyngeal and superior laryngeal nerve blocks with translaryngeal injection are required. Superior laryngeal nerve block and translaryngeal injection can be performed easily, safely and with a high success rate in patients with normal anatomy. In those with difficult landmarks, ultrasound can be of assistance. For the superior laryngeal nerve block, other targets than the nerve itself must be established to make the technique consistently successful, easy to teach, learn and perform. The same applies to the translaryngeal injection, where the use of ultrasound is necessary for correct midline identification. Intraoral glossopharyngeal nerve block is also safe and easy to perform, but associated with long lasting discomfort. Bilateral extraoral peristyloid approach should be discouraged since inadvertent blocks of the closely adjacent vagus nerve cannot be prevented in this location. A safe and easy method of blocking the distal portions of the glossopharyngeal nerve for awake intubation is therefore required.
Ključne riječi
Airway Obstruction; Respiratory System –Ultrasonography; Anesthesia, Local; Nerve Blocks; Glossopharyngeal Nerve Block; Superior Laryngeal Nerve Block
Hrčak ID:
154950
URI
Datum izdavanja:
1.3.2016.
Posjeta: 3.516 *