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Transcricothyroid injection of local anaesthesia: a serious complication
  1. Anna Li and
  2. Jason D'Costa
  1. Respiratory Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia
  1. Correspondence to Dr Anna Li; li.anna232{at}googlemail.com

Abstract

Transcricothyroid membrane (CTM) injection of local anaesthesia is widely used during bronchoscopic procedures. It is an effective way of delivering topical anaesthesia, and has been shown to reduce patient discomfort, improve clinician satisfaction and reduce overall sedation requirements. Risks from this procedure are uncommon and usually minor. Localisation of the CTM is usually performed clinically by palpation of anatomical landmarks and can vary depending on clinician skillset and experience. Clinical identification may be less accurate compared with ultrasound guidance in identifying puncture site, however, ultrasound is not always readily available and seldom used for this purpose. This case describes a rare complication following attempted local anaesthetic infiltration into the cricothyroid space, after clinical identification of puncture site. An obstructive fluid-filled mass formed around the site of injection on the right vocal cord; resulting in airway compromise, abandonment of procedure and subsequent intubation.

  • respiratory medicine
  • anaesthesia
  • otolaryngology / ENT

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Footnotes

  • Correction notice This article has been corrected since published online first. The spelling "Trans-cricoid thyroid" in the article title has been corrected to "Transcricothyroid".

  • Contributors AL was primary author, JD'C was supervising author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.