Airway management: transtracheal injection: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Airway management: transtracheal injection

Sample item

To anaesthetise the trachea and the larynx below the vocal cords before awake intubation, local anaesthetic is injected through the cricothyroid membrane into the airway. What is the characteristic response?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. A reflex cough as the drug reaches the airway

A transtracheal injection is made at end-expiration and provokes a forceful cough, which spreads the solution over the tracheal and subglottic mucosa. The technique complements the superior laryngeal nerve block, which only covers the supraglottic region. Complications are cough, bleeding and rarely laryngospasm.

Option by option

  • A. Apnoea lasting several minutes

    Apnoea is not a feature of the injection.

  • B. A reflex cough as the drug reaches the airway (correct)

    Correct. The cough is expected and helps spread the drug to the mucosa.

  • C. Immediate laryngospasm

    Laryngospasm is a rare complication, not the expected response.

  • D. Bradycardia from vagal stimulation

    Bradycardia is not typical of this technique.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, A reflex cough as the drug reaches the airway. A transtracheal injection is made at end-expiration and provokes a forceful cough, which spreads the solution over the tracheal and subglottic mucosa.

Why is "Apnoea lasting several minutes" not the answer?

Apnoea is not a feature of the injection.

Why is "Immediate laryngospasm" not the answer?

Laryngospasm is a rare complication, not the expected response.

Why is "Bradycardia from vagal stimulation" not the answer?

Bradycardia is not typical of this technique.

What concept does this question test?

It tests Airway management: transtracheal injection in Anaesthesia. The technique complements the superior laryngeal nerve block, which only covers the supraglottic region. Complications are cough, bleeding and rarely laryngospasm.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Airway management: transtracheal injection?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.