Airway Blocks for Awake Intubation

Need to anesthetize the airway? You COULD spend half an hour topicalizing the mucosa, and maybe that works in the end, but in this video we'll teach you a step by step, simple method that takes 5 minutes to do and gives you outstanding airway anesthesia.

[@marifentaqoo]

Splendid. I would like to express my deep gratitude to the doctor who played the model for undergoing a potentially dangerous act.

[@SamtaniPradeep]

That doctor is Dr Jeff Gadsden sir who is explaining us the topic too... Sir did awake intubation on himself... Truly a legend❤❤

[@Xx_LuigiFan_xx]

You're the greatest mad scientist in our field. Thanks for an amazing video.

[@stephanerasmus6732]

Absolutely love your dedication! Awesome content. Nothing says I trust a block like “okay now do them on me” 😂

[@ZzzzZz-pk2yq]

Happy Blocktober! This is a man committed to his craft! Great video!

[@akshayuttarwar3240]

Absolutely great and informative video. Thanks a lot for sharing it. Please complete this upper airway anaesthesia blocks by adding seperate video for mandibular and maxillary nerve usg guided blocks. I know not relevant for intubation, but will help greatly for surgery on maxillofacial region.

[@sleepkeeper42069]

That is a Dr. A. Bier and Archie Brain level of stardom!! You ROCK man!! Hope that was completely for demo only and not for a real surgery.

[@matthewsutton9760]

Thank you so much for this video. I have been wanting a comprehensive demonstration of this technique to ages. Will definitely be changing my practice to this

[@eclampsium]

Thanks for the increase on the repertory of techniques. I sometimes go trough topicalization and sometimes i like to make SLN and RLN blocks leaving GPN to be topicalizated. Never tried GPN block for awake intubation but have tried a few times on todlers for amigdalectomy analgesia a few times when i was in my specialization but we had once a difficult breathing after extubation in one case, wich we tought might had been due to partial anesthesia of the musculature that keeps airway patent and then i never done it again… i think it is the most risky of the three ones and that’s why i prefer going trough topicaization on GPN and block or topicalization on the other areas. I’d like to say that it’s ok going to 1% lidocaine on SLN becouse it’s a tiny nerve… Also smaller linear us probes may be usefull on this cases!

[@DocT476]

Thanks a lot for a superb video. At my institution we are regularly confronted with mechanical trismus in the maxillofacial department, so we’ve got a lot of practice with nasal awake intubations and topicalization and we do feel comfortable with doing it this way in almost all awake intubations. But I think I’m gonna want to try some of these blocks in some select case where no abscess or infection prohibit their use.

[@williamarguelloespinoza6040]

Hi ! How do you topicalizate the airway in that scenario?

[@aminudeen7654]

I use a mixture of topicalization and atomization as well as spray as you go on the vocal cords.

[@vrindavenu8639]

Awesome presentation ❤❤❤

[@asherkaz]

Thank you so much for an amazing video! 2 years ago I underwent the same training awake intubation, where I was a model and as you have clearly stated, I got a little bit too much of topical lidocaine which resulted in some light toxicity signs that subsided quickly though. RLN was covered transtracheally, SLN with cornua landmark injection, GPN with heavy topicalization of the root of the tongue and tonsils. My trainees used DL instead of FOB for awake intubation so the tongue got plenty of coverage. And yes, it took about 30 min for all setup and preparation, which is considered luxury sometimes. Do you think there is an ultrasound guided approach to glossopharyngeal nerve block? Because as you have correctly pointed out, sometimes anatomy or tumor or big tongue or all together can severely limit access to the tonsillar pillars.

[@rakshithar6252]

Well explained sir

[@timjen764]

Wow. What a video. 👏

[@dempa3]

Very interesting video! I can't help but wondering if blocking the glossopharyngeal nerve might significantly reduce the discomfort experienced during gastroduodenoscopy or TEE.

[@OmarShabana-c2t]

Yup, it very much makes it alot easier for the patient without gagging Much better experience than lidocaine spray alone

[@doristhecoder765]

You Sir are brave and awesome!

[@kimpap1]

amazing!! thanks a lot

[@miriamsolis9359]

Me encanta ❤

[@zainebali4150]

Awesome 😮

[@mikhailswartz]

Blocktober FTW! 🎉

[@williamlindores5799]

The majority of the AFOIs i've performed have been indicated for trismus; dental abscess, jaw #, Ludwigs angina etc, in this patient population is there another way to anaesthetise the GP nerve with severely restricted mouth opening?

[@urolgapporov4470]

Thanks a lot

[@briantonoindroprasto8993]

hey, is there any methods for a case of patient with angina ludwig or mandibula abcess? please answer

[@luisantonio1315]

Is a 22g spinal needle really necessary to block the GPN? I’d think it could be a struggle and painful unless you spray lido 10% before or use a 26 or 27g quincke needle

[@drdeepmaladas5600]

Thank u can u show retrograde intubation

[@seebluesea219]

Anaesthetist here. Could someone explaine why there is no motoric block of the vocal chords when anaesthetizing the RLN leading to total recurrent laryngeal nerve paresis with fatal total airway closure?

[@deroanz]

Isn't the transtracheal "block" shown here basically topicalization? So it shouldn't affect motor function

[@aiyappads7635]

Sir how about patient having Ludwig angina..

[@gaetanodibartolo5694]

This is beautiful but I find it hard to imagine any patient being willing to let me do all of that while being awake

[@branx410]

I don't see how we could safely preform these blocks in patients with fractures of the neck vertebrae.

[@i10_iO]

First

[@luiginovoa-sp]

Sir, I´m a senior 23 year experimented anesthesiologist in a public funded, third grade hospital in a medium size city in Spain, I regularly confront difficult airways in obese, or anxious or uncooperative patients, and in my opinion pretending to perform three different punctures in the airway ( like the very aggressive translaringeal approach) of a regular patient is quite delusional...

[@calandur]

¡Jopé! Ya se ve que tener un piano no se hace pianista…

[@eduardodiaz9354]

que kieres decirt exactamente

[@dengmu9142]

isn't max lidocaine 300mg?