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

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.