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Canadian Journal of Anesthesia, Vol 25, 84-91, Copyright © 1978 by Canadian Anesthesiologists' Society

Acute Epiglottitis: Current Management and Review

R. HANNALLAH M.D., F.R.C.P.(C)1 and J. K. ROSALES M.D., F.R.C.P.(C)2

1 Department of Anaesthesia, Montreal Children's Hospital; McGill University
2 Department of Anaesthesia, Montreal Children's Hospital; McGill University, Montreal, P.Q., Canada

Forty-seven patients treated for acute epiglottitis by nasotracheal intubation under general anaesthesia following a preset protocol are presented. The results are compared with 61 cases treated by tracheostomy following induction of general anaesthesia and intubation in the same institution. Both groups were followed clinically, and 13 of the children treated by nasotracheal intubation alone had a follow-up endoscopic examination of the larynx. There was no mortality in either group, but the morbidity was significantly higher in the children who had tracheostomy.

Details of the management protocol are presented. Only inhalation anaesthetic agents are recommended and it is concluded that children with acute epiglottitis should always have an artificial airway inserted. Nasotracheal intubation seems to be associated with less morbidity than tracheostomy in experienced hands.






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Copyright © 1978 by the Canadian Anesthesiologists' Society.