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Propofol-remifentanil intravenous anesthesia and spontaneous ventilation for airway foreign body removal in children with preoperative respiratory impairment
Paediatric Anaesthesia, 06/15/2012
Clinical Article
Shen X et al. – Propofol–remifentanil total intravenous anesthesia (TIVA) and spontaneous ventilation are effective and safe techniques to manage anesthesia during airway foreign body (FB) removal in children with preoperative respiratory impairment.
Methods- The authors carried out a prospective observational clinical study of FB removal using a rigid bronchoscope under propofol–remifentanil TIVA and spontaneous ventilation in 65 pediatric patients who presented with preoperative respiratory impairment.
- Heart rate, blood pressure, pulse oxygen saturation (SpO2), respiratory rate, endtidal CO2 (ETCO2), induction time, and remifentanil rate were recorded.
- Adverse events, the intervention for these events, and the duration of postoperative care were also of interest.
- Sixty children completed the study.
- The mean induction time was 12.3min.
- During the procedure, the maximum remifentanil rate was 0.14µg.kg–1.min–1.
- Light breath holding occurred in 16 (26.7%) patients.
- No severe breath holding or body movements were observed.
- An SpO2 below 90% occurred in 10 (16.7%) cases.
- No progressive desaturation was observed.
- The mean ETCO2 at the end of the procedures was 7.91KPa and returned to normal 5min after the procedure.
- In the postanesthesia care unit (PACU), no hypoxemia was observed and the mean recovery time was 23.4min.
- No laryngospasm, pneumothorax, or arrhythmias were observed.