Can Ultrasound-Guided Regional Anesthesia Techniques For Tracheostomy Be An Alternative To General Anesthesia?

Area of Science:

• Anesthesiology
• Surgical Procedures

Background:

• Cervical plexus block (CPB) is established for analgesia/anesthesia in specific surgeries but limited by perceived difficulty and risks.
• Ultrasound guidance has increased the feasibility of CPB.
• The study explores CPB's efficacy in tracheostomy, hypothesizing improved outcomes with a translaryngeal block.

Purpose of the Study:

• To evaluate the effectiveness of a combined cervical plexus block (CPB) and translaryngeal block for tracheostomy anesthesia.
• To compare analgesic consumption and patient comfort between CPB alone and the combined technique.

Main Methods:

• A double-blinded, randomized trial involving 29 patients undergoing primary tracheostomy.
• Patients received either CPB (Group S) or CPB with a translaryngeal block (Group ST).
• Primary outcome: 24-hour postoperative analgesic consumption; Secondary outcomes: pain scores, patient tolerance, cough/gag reflex, nausea/vomiting.

Main Results:

• Group ST demonstrated significantly higher patient tolerance for tracheostomy compared to Group S.
• Tracheostomy cannula comfort scores were significantly lower (better) in Group ST.
• Cough and gag reflex scores were significantly reduced in Group ST.

Conclusions:

• The combination of CPB and translaryngeal block provides excellent anesthesia and comfort for tracheostomy.
• This technique offers an effective alternative, potentially reducing the need for heavy sedation during awake tracheostomies.