Editorial Views  |   August 2016
Surgical Cricothyrotomy, Rather than Percutaneous Cricothyrotomy, in “Cannot Intubate, Cannot Oxygenate” Situation
Author Notes
  • From the Department of Anesthesiology, Dokkyo Medical University Koshigaya Hospital, Minamikoshigaya, Koshigaya City, Saitama, Japan.
  • Corresponding article on page 295.
    Corresponding article on page 295.×
  • Accepted for publication April 27, 2016.
    Accepted for publication April 27, 2016.×
  • Address correspondence to Dr. Asai: asaita@dokkyomed.ac.jp
Article Information
Editorial Views / Airway Management / Respiratory System / Technology / Equipment / Monitoring
Editorial Views   |   August 2016
Surgical Cricothyrotomy, Rather than Percutaneous Cricothyrotomy, in “Cannot Intubate, Cannot Oxygenate” Situation
Anesthesiology 8 2016, Vol.125, 269-271. doi:10.1097/ALN.0000000000001197
Anesthesiology 8 2016, Vol.125, 269-271. doi:10.1097/ALN.0000000000001197
CRICOTHYROTOMY (except for surgical tracheostomy) is regarded as the last resort in a situation of “cannot intubate, cannot oxygenate” after induction of general anesthesia,1–3  and thus, we should always be prepared to perform this task reliably in such a dire situation. Cricothyrotomy can be performed either surgically or percutaneously, and percutaneous cricothyrotomy can be performed either by the utilization of an intravenous cannula or by the use of a cricothyrotomy kit (a guidewire Seldinger type or a Trocar type). One major problem with emergency cricothyrotomy is that, because it is difficult to carry out randomized controlled studies in patients, we still do not know which method is the most reliable.4  Another problem is that, because the incidence of “cannot intubate, cannot oxygenate” situation is low, we generally would not have expertise in performing this task. In this issue of Anesthesiology, Heymans et al.5  have reported that the success rate of percutaneous cricothyrotomy was much lower than that for surgical cricothyrotomy when performed by medical students.5 
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