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.

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.

Objective:To evaluate the clinical efficacy of ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture for awake tracheal intubation in difficult airways.Methods:A total of 80 patients scheduled for general anesthesia surgery owing to difficult airways at Marine Police Corps Hospital of Chinese People's Armed Police Force from August 2019 to February 2023 were included in this prospective study. These patients were randomly divided into a control group and an observation group ( n = 40 per group). Both groups of patients underwent fiberoptic bronchoscope-guided awake tracheal intubation through the nasal route. Before intubation, the control group received surface anesthesia combined with cricothyroid membrane puncture anesthesia, while the observation group received superior laryngeal nerve block combined with cricothyroid membrane puncture anesthesia. During the intubation process, hemodynamic indicators of the patients were monitored, the duration of the intubation operation was recorded, and the degree of sedation and cough response was evaluated. Before and after intubation, the levels of serum stress response factors were determined, and the satisfaction level of patients with the intubation operation was investigated. Results:At the time points T1 (immediately after the tracheal tube enters the glottis) and T2 (after the tracheal tube enters the trachea), the heart rate in the observation group was (84.08 ± 8.25) times/minute and (82.64 ± 7.81) times/minute, respectively, and the mean arterial pressure in the observation group was (92.57 ± 8.32) mmHg (1 mmHg = 0.133 kPa) and (103.27 ± 9.16) mmHg, respectively, which were significantly lower compared with those in the control group ( t = 5.92-12.56, all P < 0.001). At T1 and T2, there was no significant difference in blood oxygen saturation (SpO 2) between the observation and control groups ( t = 0.34-0.43, P = 0.652-0.726). The duration of the intubation operation in the observation group was (8.96 ± 1.15) minutes, which was significantly shorter than (11.47 ± 1.39) minutes in the control group ( t = 6.84, P < 0.001). The Ramsay sedation score during intubation in the observation group was 3 (2,3) points, which was significantly higher than 2 (1,3) points in the control group ( Z = 9.26, P < 0.001). The cough response score in the observation group was 1 (0,1) point, which was significantly lower than 1 (0, 2) points in the control group ( Z = 4.37, P < 0.001). The serum levels of stress response factors norepinephrine and adrenaline in the observation group were significantly lower than those in the control group ( t = 14.58-25.94, both P < 0.05). The overall patient satisfaction in the observation group was 97.50%, which was significantly higher than that in the control group ( χ2 = 4.51, P = 0.034). Conclusion:Superior laryngeal nerve block combined with cricothyroid membrane puncture can be used for anesthetic management of awake nasal tracheal intubation in difficult airways. This combined approach can improve patient hemodynamic stability and sedation, shorten the duration of intubation, reduce stress responses during intubation, and enhance patient satisfaction.