Özet:

Aim: Preprocedural ultrasonographic examination of the upper airway anatomy is an effective method for deciding on a tracheostomy procedure, such as percutaneous or surgical tracheostomy. We aimed to compare the effects of superficial cervical plexus block (CPB) with translaryngeal block with those of local anesthesia infiltration to the incision site for percutaneous tracheostomy in terms of hemodynamic parameters, gag reflex, and anesthetic requirement. In addition, we evaluated the effect of preprocedural ultrasonography assessment compared with that of anatomical landmark examination in terms of reducing the risk of procedure-related complications. Materials and Methods: A total of 148 patients aged at the range of 18-99 years, who were indicated for percutaneous tracheostomy in the intensive care unit, were enrolled in the study. The data intended for this study were obtained from the hospital’s electronic patient database through retrospective scanning between 2018 and 2022. Patients who underwent ultrasonography for the evaluation of the related anatomical structures and superficial CPB with a translaryngeal block were assigned to the ultrasonography group (n=74), whereas those who underwent an anatomical landmark technique and local anesthetic infiltration to the procedure site were assigned to the traditional group (n=74). Results: The patients’ age and sex distributions did not differ significantly between the traditional and ultrasonography groups (p>0.05). In the ultrasonography group, the preprocedural, midprocedural, and postprocedural heart rates were significantly higher than in the traditional group (p<0.05). In the ultrasonography group, the mean preprocedural arterial pressure decreased significantly during and after the procedure (p<0.05). The mean arterial pressure decreased during the procedure and the postprocedural arterial pressure was significantly higher (p<0.05) in the ultrasonography group than in the traditional group. Conclusion: Although ultrasonography-guided percutaneous tracheostomy takes more time to perform than traditional anatomical landmark percutaneous tracheostomy, we claim that the procedure is much safer and provides better clinical outcomes.

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