Ultrasound-Guided Superior Laryngeal Nerve Block Facilitates Anesthesia Management in Bariatric Surgery

Patients with obesity usually have a narrow pharyngeal cavity. They are prone to exposure difficulties and intubation failure during endotracheal intubation, and even face mask oxygen supply difficulties and hypoxemia in severe cases. We described the successful completion of conscious endotracheal intubation with superior laryngeal nerve internal branch block (SLNi) in a patient with pathologic obesity. A 29-year-old, nondiabetic man with severe obesity (weight 211 kg, height 186 cm, and body mass index [BMI] 60.99 kg/m2) was scheduled for a laparoscopic sleeve gastrectomy. The superior laryngeal nerve internal branch was blocked under ultrasound guidance to eliminate the cough induced by fiberscope during awake endotracheal intubation. Why Should an Emergency Physician Be Aware of This? The cough caused by fiberscope was completely suppressed and the awake endotracheal intubation was completed successfully.