The thyrohyoid membrane as a target for ultrasonography-guided block of the internal branch of the superior laryngeal nerve

Stopar-Pintaric, Tatjana; Vlassakov, Kamen; Ažman, Josip; Cvetko, Erika

doi:10.1016/j.jclinane.2015.07.016

Cited by 19 publications

(21 citation statements)

References 8 publications

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“…Extra-planar puncture or transverse location of the thyrohyoid membrane were used to track the intra-planar puncture of the superior laryngeal artery. It was a reliable and repeatable method to use the peripheral structure of superior laryngeal nerve as a localization marker, which was consistent with the spatial anatomical structure of superior laryngeal nerve and indicated a high success rate of the blockade [16].…”

Section: Discussionsupporting

confidence: 66%

“…Awake intubation was then carried out without the discovery of any complications after iSLN by injecting local anesthetics near the superior laryngeal artery. Furthermore, prior evidence has shown that iSLN can be identified and located accurately under the guidance of ultrasound [15,16]. Many reports revealed that iSLN was difficult to visualize under ultrasound [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Many reports revealed that iSLN was difficult to visualize under ultrasound [17,18]. It was found that ibSLN could not always be displayed under ultrasound scanning, but thyrohyoid membrane and the superior laryngeal artery penetrating through the thyrohyoid membrane with internal branch of superior laryngeal nerve could be easily visualized [19]; besides, when local anesthetics were injected into the surface of thyrohyoid membrane and the "space" in the medial region of the superior laryngeal artery, satisfactory anesthetic effects were also achieved [16,17]. In our study, the high-resolution ultrasound imaging system was used to confirm the visibility of ultrasound-guided iSLN image.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

He²,

Wang³

et al. 2020

PLoS ONE

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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.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

He²,

Wang³

et al. 2020

PLoS ONE

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“…Iida et al demonstrated clinical usefulness of a similar approach by injecting lidocaine at the surface of the greater horn of the hyoid bone, using an US-guided in-plane technique in a patient with laryngeal abscess 19 . Stopar Pintaric et al, furthermore, suggested to use thyrohyoid membrane as a target plane for local anesthetic injection to make the US-guided iSLN block feasible 20 . Nevertheless, there are investigators who report being able to consistently visualize the SLN with US.…”

Section: Tatjana Stopar Pintaričmentioning

confidence: 99%

Upper Airway Blocks for Awake Difficult Airway Management

Pintarič

2016

ACC

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SUMMARY -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.

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“…Ultrasound-guided superior laryngeal nerve block is a hot topic, but it is invasive and required bilateral block. 3 Here we reported our successful experience for awake intubation through a new spray device easily converted from a spray bottle and oxygen delivery device. This converted spray device was consisted of three main parts, i.e., a glass bottle with a special spray nozzle, a simple humidifier, and a pipe for oxygen delivery ( Fig.…”

mentioning

confidence: 99%

A converted spray device for topical pharyngeal anesthesia in awake intubation

2022

Brazilian Journal of Anesthesiology (English Edition)

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The thyrohyoid membrane as a target for ultrasonography-guided block of the internal branch of the superior laryngeal nerve

Cited by 19 publications

References 8 publications

Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

Upper Airway Blocks for Awake Difficult Airway Management

A converted spray device for topical pharyngeal anesthesia in awake intubation

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