Clinical Procedure
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Surgical division or reconstruction of shortened aryepiglottic folds in children with severe stridor or respiratory obstruction due to laryngomalacia.
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Jan 27, 2013
Dexamethasone to reduce postoperative airway oedema
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Consider that post-procedure supraglottic oedema may occur despite administration of intraoperative steroids.
This may resulting in deterioration of the airway in the hours following arrival to the ward / ICU.
Consider this risk when deciding on where to send the patient and whether to send them intubated.
This may resulting in deterioration of the airway in the hours following arrival to the ward / ICU.
Consider this risk when deciding on where to send the patient and whether to send them intubated.
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Spontaneously ventilating technique
Remifentanil infusion started early (takes ~7mins to reach effect site equilibrium)
Sevoflurane induction
Propofol infusion
Nasally placed ETT with the end sitting in the posterior oropharynx to deliver oxygen (unless laser is being used) and sevoflurane
Place a hand on the patient's chest throughout the case to feel for respiratory effort
Surgeon will usually want to lighten the patient up at the end of the case with an anaesthetic laryngoscope in place (rather than the suspension laryngoscope )to look for apposition of the vocal cords.
#BM
Remifentanil infusion started early (takes ~7mins to reach effect site equilibrium)
Sevoflurane induction
Propofol infusion
Nasally placed ETT with the end sitting in the posterior oropharynx to deliver oxygen (unless laser is being used) and sevoflurane
Place a hand on the patient's chest throughout the case to feel for respiratory effort
Surgeon will usually want to lighten the patient up at the end of the case with an anaesthetic laryngoscope in place (rather than the suspension laryngoscope )to look for apposition of the vocal cords.
#BM
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Jan 27, 2013