Airway blocks

Question 1

What are the indications for a transtracheal block?

Answer 1

Block the recurrent laryngeal nerve for awake laryngoscopy, fiberoptic and/or retrograde intubation
Abolition of the gag reflex or hemodynamic responses to laryngoscopy or bronchoscopy.
Results in anesthesia of the trachea below the vocal cords
The injection of local anesthetic usually stimulates the cough reflex

Question 2

What are the indications for a superior laryngeal block?

Answer 2

Blocks the internal (sensory) branch of the SLN
Blocks the supraglottic region
Results in abolition of the gag reflex or hemodynamic responses to laryngoscopy or bronchoscopy

Question 3

What are the indications for a glossopharyngeal block? Aspirate before injecting. What if air? Blood?

Answer 3

Lingual branch of the Glossopharyngeal nerve supplies sensory to the back of the tongue
abolition of the gag reflex or hemodynamic response to laryngoscopy
When topical application is not effective
Aspirate before injecting 1-2cc of 2% lidocaine
Air= too deep
Blood= withdraw and redirect needle medially