Efficacy of double-lumen central venous catheter for airway management in children undergoing resection of laryngeal papilloma under inhalation anesthesia with sevoflurane-spontaneous breathing
10.3760/cma.j.issn.0254-1416.2013.07.027
- VernacularTitle:双腔深静脉导管用于小儿七氟醚吸入麻醉-自主呼吸下喉乳头状瘤切除术气道管理的效果
- Author:
Zhirui ZHU
;
Zhiyong HU
;
Yilei JIANG
;
Haiyan JIN
- Publication Type:Journal Article
- Keywords:
Intubation,intratracheal;
Anesthesia,inhalation;
Respiration;
Laryngeal neoplasms;
Papilloma;
Child
- From:
Chinese Journal of Anesthesiology
2013;33(7):880-882
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of double-lumen central venous catheter (DLCVC) for airway management in children undergoing resection of laryngeal papilloma under inhalation anesthesia with sevoflurane-spontaneous breathing.Methods Twenty-nine ASA physical status Ⅰ or Ⅱ podiatric patients,aged 1-9 yr,weighing 10-35 kg,scheduled for elective resection of laryngeal papilloma under self-retaining laryngoscope,were included in this study.Anesthesia was induced with inhalation of 8 ％ sevoflurane and the children kept spontaneous breathing.The larynx was sprayed with 2％ lidocaine for topical anesthesia.A self-retaining laryngoscope was inserted and a 7F DLCVC was placed below the glottis via the self-retaining laryngoscope.4％-6％ sevoflurance was insufflated via the main lumen of DLCVC (14G) to maintain anesthesia.PETCO2 was monitored through the branch lumen of DLCVC (18G).Before surgery (T1),at 20 min after the beginning of surgery (T2),and at the end of surgery (T3),arterial blood samples was obtained for blood gas analysis,and body movement,hypoxemia (SpO2 ＜ 95 ％ during oxygen inhalation),and airway management failure (SpO2 ＜ 90％ during oxygen inhalation) were also recorded.Results Compared with the baseline value at T1,although there were significant changes in PaCO2,base excess,pH value and PaO2 at T2 and T3 (P ＜ 0.05),they were all within the clinical reference ranges.There were no significant differences between PaCO2 and PETCO2 at T1,T2 and T3 (P ＞ 0.05).The incidence of body movement and hypoxemia was 10％,and the rate of airway management failure was 3％ (due to degree Ⅲ laryngeal obstruction).Conclusion DLCVC can be safely and effectively used for airway management in children with degree Ⅰ or Ⅱ laryngeal obstruction undergoing resection of laryngeal papilloma under inhalation anesthesia with sevoflurane-spontaneous breathing.
