Efficacy of airway topical anesthesia with combination of superior laryngeal nerve block and thyro-cricoid membrane puncture for tracheal intubation in pediatric patients with Pierre Robin Sequence / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of airway topical anesthesia with combination of su-perior laryngeal nerve block ( SLNB) and thyrocricoid membrane puncture for tracheal intubation in the ped-iatric patients with Pierre Robin Sequence. Methods Thirty-two American Society of Anesthesiologist physical statusⅠorⅡpediatric patients with Pierre Robin Sequence, aged 5-12 months, weighing 5-13 kg, scheduled for elective cleft palate repair under general anesthesia, were divided into 2 groups ( n=16 each) using a random number table method: control group ( group C) and airway topical anesthesia with SLNB-thyrocricoid membrane puncture group ( group ST) . After anesthesia was induced by inhaling sevoflu-rane by mask on admission to the operating room, 2％ lidocaine 0. 5 ml was injected around the bilateral su-perior laryngeal nerve under ultrasound guidance, and then 2％ lidocaine 1 ml was injected via the thyrocri-coid membrane in group ST, and the root of tongue, pharynx and larynx were sprayed with 2％ lidocaine by using a laryngotracheal mucosal atomization device in group C. The pediatric patients were tracheally intuba-ted guided by a video laryngoscope 3 min later. The development of cardiovascular responses, vocal cord activity and body movement was recorded during intubation. The intubation time, success rate of intubationat first attempt and patient′s tolerance to tube were recorded. The occurrence of postoperative hoarseness was also recorded. Results Compared with group C, the incidence of cardiovascular responses, vocal cord activity and body movement was significantly decreased, the intubation time was shortened, the suc-cess rate of intubation at first attempt was increased, and the patient′s tolerance to tube score was decreased in group ST ( P<0. 05) . Conclusion Airway topical anesthesia with combination of SLNB and thyrocricoid membrane puncture can provide better intubation conditions when used for the pediatric patients with Pierre Robin Sequence.