Application of ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture in anesthesia for older adult patients with obesity
10.3760/cma.j.cn341190-20240418-00429
- VernacularTitle:超声引导下喉上神经阻滞复合环甲膜穿刺在老年肥胖患者麻醉中的应用
- Author:
Huiying PIAO
1
;
Zhengning ZHU
1
;
Xiaoguo LIU
1
Author Information
1. 武警海警总队医院麻醉科，嘉兴 314000
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Anesthesia;
Nerve block;
Laryngeal nerves;
Intubation, intratracheal;
Hemodynamics;
Stress disorders, traumatic;
Obesity;
Aged
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(10):1487-1491
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the application effects of ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture on anesthesia for older adult patients with obesity.Methods:A case-control study was conducted on the clinical data of 85 older adult patients with difficult airways who underwent surgical treatment at Marine Police Corps Hospital of Chinese People's Armed Police Force from March 2021 to June 2023. Based on the different methods of anesthesia for tracheal intubation, the patients were divided into a control group ( n = 40) and an observation group ( n = 45). The control group received conventional superior laryngeal nerve block combined with cricothyroid membrane puncture, while the observation group received ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture. The success rate of tracheal intubation, time taken for tracheal intubation, hemodynamic indicators, stress indicators, and the incidence of adverse reactions related to anesthesia were compared between the two groups. Results:In the observation group, the first-attempt tracheal intubation success rate was 87% (39/45), and the overall success rate for tracheal intubation was 98% (44/45), both of which were significantly higher than those in the control group [68% (27/40), 95% (38/40); χ2 = 4.48, 4.58, both P<0.05]. The time taken for tracheal intubation in the observation group was significantly shorter than that in the control group [(36.41 ± 5.23) minutes vs. (39.50 ± 4.42) minutes; t = 2.98, P<0.05]. During tracheal intubation and at the start of surgery, the observation group exhibited lower heart rates and higher mean arterial pressures compared with the control group ( t = 4.58, 4.65, -1.90, -2.14, all P<0.05). The cortisol and norepinephrine concentrations in the observation group were (23.12 ± 1.63) ng/L and (1 436.13 ± 225.60) pmol/L, respectively, both of which were significantly lower than those in the control group [(28.33 ± 2.29) ng/L, (1 784.50 ± 217.79) pmol/L; t = 12.59, 7.39, both P<0.05]. The incidence of anesthesia-related adverse reactions in the observation group was significantly lower than that in the control group [7% (3/45) vs. 25% (10/40); χ2 = 4.17, P<0.05]. Conclusions:Ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture can enhance the success rate of tracheal intubation prior to general anesthesia in older adult patients with obesity. This approach helps maintain hemodynamic stability, reduces stress responses, and demonstrates a high level of safety.
