Development of a novel device for ultrasound-guided cricothyroidotomy

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K09205
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Kyorin University
• Principal Investigator: Tokumine Joho 杏林大学, 医学部, 教授 (70274909)
• Co-Investigator(Kenkyū-buntansha): 中澤 春政 杏林大学, 医学部, 准教授 (10458888)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 気道確保困難 / 外科的気道確保 / 輪状甲状間膜穿刺 / 輪状甲状間膜切開 / 超音波ガイド

Outline of Final Research Achievements

When an airway cannot be secured after induction of general anesthesia, the last resort is a cricothyroid membrane puncture or incision. However, the success rate of cricothyroid membrane puncture by anesthesiologists is reportedly low. On the other hand, it has been found that ultrasound observation is more accurate than conventional palpation in identifying the cricothyroid membrane, which is related to the success rate of puncture. Therefore, we developed a new cricothyroidotomy needle that is safe and accurate by identifying the cricothyrotomy with ultrasound. We compared the developed puncture needle, commercially available puncture needles, and the incision method currently considered the standard technique, using the cricothyroid membrane of the porcine larynx. The ultrasound-guided cricothyroidotomy needle was suggested to be the safest, although it took longer to perform than the other methods.

Free Research Field

気道エコー

Academic Significance and Societal Importance of the Research Achievements

今回、世界で初めて、超音波ガイドによる輪状甲状間膜穿刺針を開発した。この針は、安全確実に輪状甲状間膜穿刺が行える。問題は、この方法がガイドワイヤーを使用するSeldinger法ため、やや迅速性に欠ける点にある。このため、本穿刺針は、予期できなかった緊急の気道確保困難よりも、事前に予期される気道確保困難に対して、安全確実に輪状甲状間膜穿刺が行える器具として価値がある。現在、予期された気道確保困難に対し、意識下挿管および輪状甲状間膜穿刺の準備を同時並行で進める方策が推奨されている。本穿刺針は、血腫、腫瘍および顔面変形等が引き起こす輪状甲状間膜の位置異常に対処できる器具として期待されるであろう。