title: Ultrasound-guided airway blocks using a curvilinear probe.
abstract: We describe a novel technique of real-time ultrasound-guided superior laryngeal nerve and translaryngeal blocks in 4 patients with anticipated difficult airways. All patients had altered neck anatomy, and 1 had a prior unsuccessful awake fiberoptic bronchoscopic intubation. For block performance, an 11-mm broadband curved array transducer with a scanning frequency between 8 and 5 MHz (Sonosite, Bothell, WA) was used for anatomical structure identification, needle guidance toward each superior laryngeal nerve and through the cricothyroid membrane, and deposition of local anesthetic in the appropriate location. This was followed by successful awake fiberoptic bronchoscopic endotracheal intubation in all cases.
authors.affiliation: University of California San Diego, 200 West Arbor Drive #8770, San Diego, CA 92103, USA; Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Krause
authors.affiliation: University of California San Diego, 200 West Arbor Drive #8770, San Diego, CA 92103, USA.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Khatibi
authors.affiliation: University of California San Diego, 200 West Arbor Drive #8770, San Diego, CA 92103, USA.
authors.forename: Jacklynn F
authors.initials: JF
authors.lastname: Sztain
authors.affiliation: University of California San Diego, 200 West Arbor Drive #8770, San Diego, CA 92103, USA.
authors.forename: Pariza
authors.initials: P
authors.lastname: Rahman
authors.affiliation: University of California San Diego, 200 West Arbor Drive #8770, San Diego, CA 92103, USA; Stanford University, 300 Pasteur Drive, Palo Alto, CA 94304, USA.
authors.forename: Anna B
authors.initials: AB
authors.lastname: Shapiro
authors.affiliation: University of California San Diego, 200 West Arbor Drive #8770, San Diego, CA 92103, USA. Electronic address: nsandhu@ucsd.edu.
authors.forename: NavParkash S
authors.initials: NS
authors.lastname: Sandhu
mesh_terms: D000368:Aged; D000402:Airway Obstruction; D000769:Anesthesia, Inhalation / Q000295:instrumentation*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001999:Bronchoscopy; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007823:Laryngeal Nerves; D007828:Laryngoscopy; D007830:Larynx / Q000000981:diagnostic imaging*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D014159:Transducers; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Awake intubation; Difficult airway; Superior laryngeal nerve block; Translaryngeal injection; Ultrasound-guidance