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Canadian Journal of Anesthesia, Vol 28, 561-566, Copyright © 1981 by Canadian Anesthesiologists' Society

Anaesthetic Experience Using a Standard Technique for Laryngeal Surgery in Infants and Children

M. G. KENNEDY 1, H. M. CHINYANGA 1, and D. J. STEWARD 1

1 Department of Anaesthesia, The Hospital For Sick Children, Toronto, Ontario, Canada

A 12 year review is presented of 1922 anaesthetic experiences on 285 patients presenting for microlaryngeal operations at the Hospital For Sick Children, Toronto. The lesions treated were laryngeal growths, 198 cases (69.5 percent); subglottic stenosis, 81 cases (28.4 percent); and posterior laryngeal cleft, 6 cases (2.1 percent). The anaesthetic technique consisted of topical analgesia with lidocaine spray (3 mg·kg-1) and pharyngeal insufflation of halothane and methoxyflurane both 1-1.5 percent in oxygen through a special channel in the blade of a Jako Pilling microlaryngoscope in spontaneously breathing patients.

Arterial blood gases sampled after 15 and 40 minutes of anaesthesia showed Paco2 = 6.29 ± 0.31 kPa(47.1 ± 2.39 torr) and 6.44 ± 0.16kPa (48.1 ± 1.22 torr); Pao2 = 29.06 ± 4.33 kPa (218 ± 32.5 torr) and 37.06 ± 4.82 kPa (278 ± 36.2 torr) respectively. Surgical exposure of the larynx was good allowing for a shorter operative time with minimal perioperative complications, in only 94 (4.89 per cent) of the 1922 anaesthetics.

Key Words: ANAESTHETIC TECHNIQUES, insufflation • SURGERY, laryngeal, infants and children






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Copyright © 1981 by the Canadian Anesthesiologists' Society.