From the Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan.
Department of Anesthesia, Ogikubo Hospital, Tokyo, Japan.
A A Pract. 2023 May 9;17(5):e01682. doi: 10.1213/XAA.0000000000001682. eCollection 2023 May 1.
A peripheral nerve block may be used to improve patient tolerance of awake intubation. During an awake intubation, the glossopharyngeal, superior laryngeal, and recurrent laryngeal nerves can mediate discomfort, pain, cough, glottic closure, and gag reflexes. We describe the use of ultrasound-guided superior laryngeal, recurrent laryngeal, and glossopharyngeal nerve blocks to facilitate awake intubation in a patient predicted to have a difficult airway. The glossopharyngeal nerve block was performed via the parapharyngeal space approach targeting the distal glossopharyngeal nerve. This procedure resulted in an uneventful awake intubation.
周围神经阻滞可用于提高患者对清醒插管的耐受性。在清醒插管过程中,舌咽神经、喉上神经和喉返神经可引起不适、疼痛、咳嗽、声门关闭和咽反射。我们描述了使用超声引导的喉上神经、喉返神经和舌咽神经阻滞来促进预测有困难气道的患者进行清醒插管。通过经咽旁间隙入路对远端舌咽神经进行舌咽神经阻滞。该操作使清醒插管顺利进行。