ObjectiveTo explore the clinical efficacy of the ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture applied to awake tracheal intubation by branchofiberoscope. MethodsForty patients scheduled for general anesthesia (ASA grade Ⅰ-Ⅱ) were enrolled and underwent awake tracheal intubation. The patients were divided into surface anesthesia combined with cricothyroid membrane puncture group （conventional group）and ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture group（ultrasound group）using random number table, with 20 cases in each group. The MAP, HR and SpO2 were recorded before anesthesia (T1), during tracheal intubation (T2) and after intubation (T3). The incidence of complications was also recorded, including cough, irritation, nausea and vomiting, and the satisfaction degree of patients during follow-up. ResultsIn both groups, the MAP and HR at T2 and T3 were significantly higher than those at T1 (P＜0.05). Compared with the conventional group, the MAP and HR at T2 and T3, and the rate of intubation related adverse reaction was significantly lower, the successful rate of intubation and the score of patients′ satisfaction degree were higher in the ultrasound group (P＜0.05). ConclusionCompared to conventional oral pharynx and larynx surface anesthesia, ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture is more suitable for awake tracheal intubation in patients with difficult airway, can obtain less stress response and better acceptance of the patient′s and has less complications.

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