Ultrasound-Guided Glossopharyngeal Nerve Block for an Awake Intubation in a Patient Predicted to Have a Difficult Airway: A Case Report.

A peripheral nerve block may be used to improve patient tolerance of awake intubation. During an awake intubation, the glossopharyngeal, superior laryngeal, and recurrent laryngeal nerves can mediate discomfort, pain, cough, glottic closure, and gag reflexes. We describe the use of ultrasound-guided superior laryngeal, recurrent laryngeal, and glossopharyngeal nerve blocks to facilitate awake intubation in a patient predicted to have a difficult airway. The glossopharyngeal nerve block was performed via the parapharyngeal space approach targeting the distal glossopharyngeal nerve. This procedure resulted in an uneventful awake intubation.

Use of a photoacoustic needle improves needle tip recognition in a video recording of simulated ultrasound-guided vascular access: A pilot study.

BACKGROUND: We developed a novel photoacoustic needle, which emits ultrasound produced by the photoacoustic effect. This study focused on the most common "pitfall" associated with placement during ultrasound-guided vascular access, which is misidentification of the needle tip. METHODS: The study was conducted as a prospective cohort study using a questionnaire. The authors intentionally created two successful and one failed ultrasound-guided central venous catheterization videos using the photoacoustic needle on a simulator. Each of these three videos was then split into two movies for viewing, one with standard ultrasound images only and the second including the images from the photoacoustic needle, for a total of six movies. RESULTS: Participants who were 18 anesthesiologists, 12 residents, and 10 medical students, watched each of the six movies and completed a survey whether the puncture was successful or not. In the results, there was a significant difference in the percentage of correct answers whether the movie depicted successful or failed puncture with and without the photoacoustic ultrasound (p = 0.0001). CONCLUSION: The novel photoacoustic needle improved the ability to identify the needle tip on recorded videos. It may have efficacy to prevent serious mechanical complication during the ultrasound-guided vascular access in clinical practice.