Abstract: Objective To explore the efficacy of the ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture for awake tracheal intubation in patients with cervical spinal cord injury.
Methods Eighty patients with cervical spinal cord injury scheduled for selective surgery under awake tracheal intubation were enrolled .The patients were randomly divided into two groups(n=40): control group and ultrasound group.Control group received superior laryngeal nerve block combined with cricothyroid membrane puncture using the acupoint-located method by anatomical landmark. Ultrasound group received ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture.The mean arterial pressure(MAP) and heart rate(HR) were recorded at the time of burglary (T0 ),before the endotracheal tube into the nasopharynx (T1 ), endotracheal tube into the glottis immediately(T2 ), 5 min after intubation (T3 ). The time of intubation, the success rate of intubation were recorded.The incidence of complications were also recorded,including cough,nausea and vomiting,and the tolerance degree of tube postoperative.
Results The mean arterial pressure and heart rate of T1, T2 and T3 in the control group were significantly higher than T0(P＜0.05). There was no significant difference in the mean arterial pressure and heart rate of T1, T2 and T3 between two groups(P＞0.05). The incidence of choking in the ultrasound group was significantly lower than that in the control group(P＜0.05). The degree of tube resistance in the ultrasonic group was higher than that in the control group(P＜0.05).
Conclusion Ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture can meet the needs of conscious tracheal intubation through nose, with stable hemodynamics and less adverse reactions.

Key words: spinal cord injuries, punctures, ultrasonography