1.1 Airway Anaesthesia

Question 1

AFOI LA
aims

Answer 1

Topicalisation - patient comfort & compliance
increasing success rates

Question 2

AFOI Diff topical methods

Answer 2

1. Ensure toxic dose not exceeded
2. 2% lido gel / 4 or 10% Lido spray
   direct to nose and mouth (tongue + oropharynx)
3. Gauze soaked in 5% cocaine or lidocaine/phenylephrine into cavity
4. Mucosal atomiser / cannula -> spray into
5. Spray as you during procedure - side port on scope
   -16g epidural catheter w/ 2ml leur lock- down port

Question 3

AFOI Regional 3 methods

Answer 3

1. Anterior Glossopharyngeal nerve block
2. External Superior Laryngeal Nerve block
3. Trans-laryngeal Anaesthesia

Question 4

AFOI Regional -

1 Anterior Glossopharyngeal Nerve block

Answer 4

1. Anterior Glossopharyngeal nerve block
   - sitting facing
   - mouth open and tongue to side
   - U/J shape base palata to lateral margin tongue - .5cm from margin @floor mouth
   -25g spinal needle - aspirate (air withdraw)(bood medial)
   -inject 2ml 2% lido & repeat other side

Question 5

AFOI

2. External Superior Laryngeal Nerve block

Answer 5

2. External Superior Laryngeal Nerve block

• Sitting
• Superior cornu of hyoid (angle mandible / medial to carotid
• ID sup cornu of thyroid cartilage palp sup border until inferior to superior cornu of hyoid
• walk 25g needle anteriorly and superiorly along cornu of thyroid cartilage - aim lower 3rd of thyrohyoid membrane
• a give - indicate introduction thru membrane
• aspirate: air superficial blood redirect
• inject 2ml 2% lidocaine w/ 1:200k adrenaline

Question 6

3. Trans-laryngeal Anaesthesia

Answer 6

Supine - Neck extended

Skin clean pre

Cricothyroid membrane + apply bleb LA skin

Stabilise trachea - 20g cannula caudally - aspirate

Once in trachea - advance cannula remove needle

inject 3-4ml 4% LA

Cough - disperse LA to vocal cords and down to carina