scholarly journals Ultrasound-Guided Bilateral Superior Laryngeal Nerve Block to Aid Awake Endotracheal Intubation in a Patient with Cervical Spine Disease for Emergency Surgery

2010 ◽  
Vol 38 (5) ◽  
pp. 946-948 ◽  
Author(s):  
S. Manikandan ◽  
P. K. Neema ◽  
R. C. Rathod
Keyword(s):  
Cervical Spine ◽  
Endotracheal Intubation ◽  
Nerve Block ◽  
Emergency Surgery ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Spine Disease

scholarly journals Unilateral blindness following superior laryngeal nerve block for awake tracheal intubation in a case of posterior cervical spine surgery

2020 ◽  
Vol 11 ◽  
pp. 277
Author(s):  
Ali Akhaddar ◽  
Hassan Baallal ◽  
Nabil Hammoune ◽  
Salaheddine Bouabbadi ◽  
Amine Adraoui ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Nerve Block ◽  
Subcutaneous Emphysema ◽  
Nasotracheal Intubation ◽  
Cranial Nerves ◽  
Anterior Segment ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Pure Oxygen ◽  
Patient Reported

Background: Superior laryngeal nerve block (SUPLANEB) is a popular airway anesthesia technique utilized for successful awake endotracheal intubation in patients with significant cervical spine instability. If not performed by an expert, it carries the risk of general/neurologic complications that are typically minimal/transient. However, permanent blindness and/or upper cranial nerve neuropathies may occur. Here, we describe a case in which a young patient underwent an atlantoaxial fusion for a C2 nonunion (e.g., following a fracture) complicated by unilateral blindness due to a SUPLANEB. Case Description: A 25-year-old neurologically intact male underwent a C1-C2 posterior arthrodesis to address a nonunion of a C2 fracture. To perform the awake nasotracheal intubation, a SUPLANEB was performed using a video laryngoscope. Although the operation was uneventful, postoperatively, the patient reported left visual loss accompanied by left-sided facial numbness and hearing loss. On examination of the left eye, the anterior segment and fundus examinations were normal, but the OCT (optical coherence tomography) and retinal angiography demonstrated left-sided postischemic retinal edema with permeability of the intraocular vessels. Although the cranio-orbital computed tomography scan showed only mild pneumocephalus, the CT angiogram scan revealed abnormal air in the left carotid sheath accompanied by diffuse subcutaneous emphysema. Further, brain and orbital magnetic resonance imaging scans were normal. The patient was treated with pure oxygen, systemic steroid therapy, and nimodipine. The pneumocephalus and subcutaneous emphysema resolved on day 3. At 2 months follow-up, the patient remained blind on the left side, but had no further neurological deficits. Conclusion: Blindness and upper cranial nerves neuropathies should be considered as potential complications of SUPLANEB. Notably, these deficits were not directly related to the operative positioning or neurosurgical spinal procedure.

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 Ultrasound-guided superior laryngeal nerve block assists in anesthesia for bronchoscopic surgical procedure

Medicine ◽  
2020 ◽  
Vol 99 (27) ◽  
pp. e20916
Author(s):  
Yu-Chen Liao ◽  
Wei-Ciao Wu ◽  
Ming-Hui Hsieh ◽  
Chuen-Chau Chang ◽  
Hsiao-Chien Tsai
Keyword(s):  
Nerve Block ◽  
Surgical Procedure ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Ultrasound Guided

scholarly journals Ultrasound-guided superior laryngeal nerve block - A description of the technique

2020 ◽  
Author(s):  
Yulian Camilo Echeverri-Ospina ◽  
Mario Andrés Zamudio Burbano ◽  
Daniela González Giraldo
Keyword(s):  
Airway Management ◽  
Airway Obstruction ◽  
Nerve Block ◽  
Superior Laryngeal Nerve ◽  
Upper Airway ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Common Cause ◽  
Adequate Ventilation ◽  
Several Variables

Complications in airway management remain a common cause of anesthesia-associated mortality. When a patient is considered with anticipated difficult airway, the management depends on several variables, however, at present, the standard of management continues to be the patient awake approach. In scenarios of acute upper airway obstruction, the only way to guarantee adequate ventilation is to obtain a translaryngeal or transtracheal access, for which, it is necessary to use local anesthesia and grade I / II sedation, avoiding loss of spontaneous ventilation. For this purpose, we propose ultrasound-guided superior laryngeal nerve block, in order to standardize an ultrasound landmark that is reproduceable, with a high success rate, which allows limiting complications related to regional anatomic techniques and thus facilitating the securing of the airway in these patients.

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