Impact of cricothyroid membrane puncture anesthesia on elderly patients undergoing endotracheal intubation after anesthesia induction: a clinical study

Objective This study investigated the clinical effects of cricothyroid membrane puncture (CMP) anesthesia surface anesthesia following anesthesia induction on elderly patients undergoing endotracheal intubation (ETI). Methods Eighty elderly patients scheduled for general anesthesia with endotracheal intubation at our hospital from January to December 2023 were enrolled and randomly assigned (n = 40 each) to a study group or a control group. After intravenous anesthesia induction, the study group received 2% lidocaine via CMP for surface anesthesia, while the control group received no CMP administration. The incidence of coughing during extubation in the emergence phase, first-attempt intubation success, hypoxemia, hypotension, and vasoactive drug use were recorded. Hemodynamic parameters and adverse events were compared between groups. Results All patients achieved successful first-attempt intubation. There were no significant differences in hypoxemia incidence between groups ( P > 0.05). The study group had lower rates of hypotension and vasoactive drug use compared with the control group ( P < 0.05), as well as a lower incidence of coughing during extubation ( P < 0.05). At T0, heart rate (HR), systolic blood pressure (SBP), mean arterial pressure (MAP), and SpO 2 did not differ significantly ( P > 0.05). At T1-T3, HR, SBP, and MAP were significantly lower in the study group ( P < 0.05), with no significant differences in SpO 2 ( P > 0.05). Total adverse event rates were similar between groups ( P > 0.05). Conclusion CMP surface anesthesia following anesthesia induction in elderly patients provides favorable clinical effects by improving hemodynamic stability and reducing coughing during emergence, without increasing adverse events.