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Pediatric airway surgery under spontaneous respiration using high-flow nasal oxygen.
Int J Pediatr Otorhinolaryngol. 2020 Jul; 134:110042.IJ

Abstract

OBJECTIVES

In pediatric airway surgery, SponTaneous Respiration using IntraVEnous anesthesia and Hi-flow nasal oxygen (STRIVE Hi) has not been well explored. Here, we report our experience of using STRIVE Hi in endoscopic evaluations and surgeries of the pediatric airway.

METHODS

This retrospective review was based on 45 airway procedures conducted under STRIVE Hi, performed by a single surgeon at a single institute from May 2017 to September 2018. After induction of anesthesia, continuous infusion with propofol and remifentanil was provided to ensure an adequate level of anesthesia and supply of humidified oxygen via a nasal cannula. Monitoring was conducted using a transcutaneous CO2 sensor and a pulse oximeter, and the oxygen reserve and bispectral indexes were measured. No muscle relaxant was administered.

RESULTS

The median age of the patients was 16.0 months (range: 1-215 months) and the median weight was 10.2 kg (range: 2.4-38.5 kg). The median duration of spontaneous respiration was min 40 (range: 10-140 min). The airway procedures included diagnostic microlaryngoscopy, tracheocutaneous fistula excision, balloon dilation, supraglottoplasty, laryngeal cleft repair, injection laryngoplasty, papilloma excision, and subglottic cyst removal. During these procedures, STRIVE Hi facilitated evaluation of dynamic obstruction of the airway and the immediate outcome of surgical treatment and provided a good surgical view. Intubation and the termination of spontaneous respiration were required in only five patients.

CONCLUSIONS

STRIVE Hi is an effective and feasible anesthesia option in pediatric airway surgery. It provides unobstructed surgical access and is applicable to a wide range of procedures.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea. Electronic address: otolarynx@snuh.org.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32302883

Citation

Ji, Jeong-Yeon, et al. "Pediatric Airway Surgery Under Spontaneous Respiration Using High-flow Nasal Oxygen." International Journal of Pediatric Otorhinolaryngology, vol. 134, 2020, p. 110042.
Ji JY, Kim EH, Lee JH, et al. Pediatric airway surgery under spontaneous respiration using high-flow nasal oxygen. Int J Pediatr Otorhinolaryngol. 2020;134:110042.
Ji, J. Y., Kim, E. H., Lee, J. H., Jang, Y. E., Kim, H. S., & Kwon, S. K. (2020). Pediatric airway surgery under spontaneous respiration using high-flow nasal oxygen. International Journal of Pediatric Otorhinolaryngology, 134, 110042. https://doi.org/10.1016/j.ijporl.2020.110042
Ji JY, et al. Pediatric Airway Surgery Under Spontaneous Respiration Using High-flow Nasal Oxygen. Int J Pediatr Otorhinolaryngol. 2020;134:110042. PubMed PMID: 32302883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pediatric airway surgery under spontaneous respiration using high-flow nasal oxygen. AU - Ji,Jeong-Yeon, AU - Kim,Eun-Hee, AU - Lee,Ji-Hyun, AU - Jang,Young-Eun, AU - Kim,Hee-Soo, AU - Kwon,Seong Keun, Y1 - 2020/04/08/ PY - 2019/10/26/received PY - 2020/04/05/revised PY - 2020/04/05/accepted PY - 2020/4/18/pubmed PY - 2020/4/18/medline PY - 2020/4/18/entrez KW - High-flow nasal oxygen KW - Pediatric airway surgery KW - Pediatric anesthesia KW - Spontaneous respiration SP - 110042 EP - 110042 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 134 N2 - OBJECTIVES: In pediatric airway surgery, SponTaneous Respiration using IntraVEnous anesthesia and Hi-flow nasal oxygen (STRIVE Hi) has not been well explored. Here, we report our experience of using STRIVE Hi in endoscopic evaluations and surgeries of the pediatric airway. METHODS: This retrospective review was based on 45 airway procedures conducted under STRIVE Hi, performed by a single surgeon at a single institute from May 2017 to September 2018. After induction of anesthesia, continuous infusion with propofol and remifentanil was provided to ensure an adequate level of anesthesia and supply of humidified oxygen via a nasal cannula. Monitoring was conducted using a transcutaneous CO2 sensor and a pulse oximeter, and the oxygen reserve and bispectral indexes were measured. No muscle relaxant was administered. RESULTS: The median age of the patients was 16.0 months (range: 1-215 months) and the median weight was 10.2 kg (range: 2.4-38.5 kg). The median duration of spontaneous respiration was min 40 (range: 10-140 min). The airway procedures included diagnostic microlaryngoscopy, tracheocutaneous fistula excision, balloon dilation, supraglottoplasty, laryngeal cleft repair, injection laryngoplasty, papilloma excision, and subglottic cyst removal. During these procedures, STRIVE Hi facilitated evaluation of dynamic obstruction of the airway and the immediate outcome of surgical treatment and provided a good surgical view. Intubation and the termination of spontaneous respiration were required in only five patients. CONCLUSIONS: STRIVE Hi is an effective and feasible anesthesia option in pediatric airway surgery. It provides unobstructed surgical access and is applicable to a wide range of procedures. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/32302883/Pediatric_airway_surgery_under_spontaneous_respiration_using_high-flow_nasal_oxygen L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(20)30185-3 DB - PRIME DP - Unbound Medicine ER -
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