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Purpose: To report our experience with directly cricothyroid membrane puncture anesthesia for tracheal or bronchial stent placement.Materials and methods: Medical records of 28 consecutive patients who underwent directly cricothyroid membrane puncture anesthesia for tracheal or bronchial stent placement.The laryngeal prominence was touched and puncture site was choosen at the interspaces between the thyroid cartilage and cricoid cartilage.The syringe with 2% lidocaine hydrochloride penetrates the cricothyroid membrane and the lidocaine was injected into the trachea to suppress the cough reflex.Covered stents was placed fluoroscopically in 28 patients at the trachea or bronchus.Success rate and complication of cricothyroid membrane puncture anesthesia were evaluated.Results: Success of anesthesia was achieved in all of the cases.Six patients including one patient with fistula need supplementary lidocaine 2-4 mL through the catheter or stent delivery system.Technical success of the stent placement was achieved in all of the cases.Small asymptomatic subcutaneous suggillation was occurred in two patients and disappeared one day and two days after stent placement without any treatment,respectively.Conclusion: directly cricothyroid membrane puncture anesthesia for tracheal or bronchial stent placement is a safe and effective method.