Anesthetic management for an infant undergoing endoscopic resection of a large subglottic papiloma

Xia Shen, MD., Wenxian Li, MD.
Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.

Background: An infant with a large subglottic papilloma that caused severe respiratory distress needed anesthesia during resection of the papilloma. Aims: We planned an approach to the airway management this infant that we thought would be successful. Methods: We used three main tactics in managing the airway – inhaled sevoflurane, intravenous fentanyl and the patient’s resumed spontaneous breathing. We also allowed the otolaryngologist to quickly resect some of the papilloma before intubation. Results: Our patient’s airway was managed successfully, and the papilloma was removed. Conclusions: Management of the airway in a small child with obstruction can be aided by inducing anesthesia with sevoflurane, deepening anesthesia with intravenous fentanyl, and allowing the patient to resume spontaneous breathing. (Shen X, Li W. Anesthetic management for an infant undergoing endoscopic resection of a large subglottic papiloma. North Am J Med Sci 2009; 1: 83- 85).

Key words: Airway, obstruction, anesthesia, sevoflurane, spontaneous breath, papilloma.

Correspondence to: Dr. Wenxian Li. Department of Anesthesiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China. Tel. 21 64377134 766, Fax: + 21 64377134 766. Email:wenxianli66@gmail.com