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Superior laryngeal nerve block: an anatomical study
M Stockwell1, S Lozanoff, S A Lang
1Department of Anaesthesia, University of Saskatchewan, Saskatoon, Canada.
Clinical Anatomy (New York, N.Y.)
|January 1, 1995
Summary
A modified technique for superior laryngeal nerve anesthesia using a short bevel needle simplifies awake endotracheal intubation. This improved method achieved a 97.5% success rate in anatomical studies.
Area of Science:
- Anesthesiology
- Anatomy
Background:
- Superior laryngeal nerve anesthesia is crucial for awake endotracheal intubation.
- Conventional transcutaneous approaches can be challenging to perform accurately.
Purpose of the Study:
- To determine the anatomical basis of superior laryngeal nerve anesthesia.
- To evaluate the success rate of a modified transcutaneous technique using a short bevel needle.
Main Methods:
- Cadaveric study involving 20 autopsies with 0.02% methylene blue injection.
- Detailed dissection to identify stained anatomical structures.
- Additional dissections on formalin-fixed cadavers.
Main Results:
- The anesthetic spread into the paraglottic space, effectively staining the internal laryngeal nerve.
- The lateral glossoepiglottic fold provided needle resistance, contrary to expectations.
- A 97.5% success rate (39 out of 40 injections) was achieved.
Conclusions:
- The modified technique offers a simple and highly successful approach to superior laryngeal nerve anesthesia.
- Improved tactile feedback with the short bevel needle aids in accurate injection depth identification.