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Airway obstruction during general anaesthesia in a child with congenital tracheomalacia

Published online by Cambridge University Press:  16 August 2006

Y. Okuda
Affiliation:
First Department of Anaesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293, Japan
H. Sato
Affiliation:
First Department of Anaesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293, Japan
T. Kitajima
Affiliation:
First Department of Anaesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293, Japan
T. Asai
Affiliation:
Department of Anaesthesiology, Kansai Medical University, Moriguchi city, Osaka, 570-8507, Japan
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Abstract

Fibreoptic bronchoscopy is often used to diagnose tracheomalacia under local anaesthesia. However, in children, general anaesthesia may be required due to difficulty in obtaining co-operation. A 1-yr-old girl with a suspected congenital tracheomalacia was scheduled for diagnostic fibreoptic bronchoscopy. During induction of anaesthesia by inhalation of increasing concentration of sevoflurane, spontaneous breathing became irregular and a partial airway obstruction occurred. Because vecuronium relieved the airway obstruction, the airway was managed using a laryngeal mask. No further airway obstruction occurred during fibrescopy under controlled ventilation, but when spontaneous breathing resumed, marked airway obstruction occurred. The trachea was intubated immediately. Caution is required to manage the airway without tracheal intubation during general anaesthesia in the patient with tracheomalacia.

Type
Clinical Letter
Copyright
2000 European Society of Anaesthesiology

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