[Application of surgical cricothyrotomy in emergency and complicated airway management]

Abstract

Objective:To explore the feasibility of intercricothyrotomy in emergency airway management. Method:Characteristics of 27 cases underwent surgical cricothyrotomy were analyzed. Result:The main causes of emergency were severe trauma of head and neck, larynx stenosis, interspaces infection of the floor of the mouth and submaxillary space, etc; all the patients were divided into 2 groups : surgical cricothyrotomy as the first choice (group A,16/27) and surgical cricothyrotomy after conventional tracheotomy (group B,11/27); The average time of opening airway for group A was much shorter than group B ［(58.12±24.41)s, (739.09±245.29)s,respectively, P<0.01)］; Bleeding in group A (14 cases) was much less than group B (13 cases) ［(2.36±1.16)ml, (4.65±4.31)ml,respectively, P<0.01］; Except 1 cases died from primary disease, 4 cases with laryngeal stenosis underwent laryngeal dilation with T type expansion tube and 2 cases of bilateral recurrent laryngeal nerve palsy, the average time with tracheal tube of the remaining 20 patients was (12.35±7.29)d, no postoperative complications such as larynx or tracheal stenosis were found. All of them were successfully extubation. Conclusion:Surgical cricothyrotomy procedure is fast and safe with simple and convenient that can be used as the preferred method of rapid airway opening when a critical respiratory tract was difficult to manage.

Keywords: airway management; airway opening; complication; etiology; surgical cricothyrotomy.