Airway Blocks

Question 0

1a. Which pt not a candidate for airway block?

Answer 0

Concern about n/v, aspiration,
If preservation of active cough reflexes is desired
Refusal, uncooperative, anticougulopathybdistored anotomy

Question 1

1. Pt at risk for difficult intubation

Answer 1

Facial trauma, 
Distortion of upper airway by access or malignany
Hx of previous difficult intubation
Cervical radiculopathy
Severe respiratory distress 
Morbid obese

Question 2

3. Additional Meds for fiberoptic intubation

Answer 2

Vasonstricors: cocaine 4%, lidocaine 3% with .25% Phenylephrine or 1:200000 epinephrine
Sedative: versed, fentanyl, dexmedetomidine
Robinul

Question 3

4. Topical Anesthetics for fiberoptic anesthesia

Answer 3

• Lidocaine 1-1.5%- direct blockade of the superior laryngeal n
• Topical anesthesia requires higher concentration oral sprays 10%
• nebulizer: 10ml of 4% lido or tetracaine .5% to 1%, also transtracheal injection or oral topical application

Question 4

5. Common airway blocks list

Answer 4

Glossopharyngeal n block
Superior laryngeal n block
Recurrent laryngeal n block
Palatine n block awake nasal intubation FOB
Anterior ethmoid n block awake nasal FOB