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Anesthetic management during tracheotomy in a child with respiratory distress caused by severe intubation-induced glottic stenosis

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Abstract

We provided anesthetic management during a tracheotomy procedure for a child who demonstrated labored respiration during inspiration because of severe glottic stenosis and bilateral vocal cord paralysis caused by tracheal intubation. A 4-year-old boy developed acute respiratory depression associated with influenza pneumonia and had been under respiratory management with mechanical ventilation with tracheal intubation for 3 days. Following extubation, an upper-airway obstruction immediately appeared. The symptoms later worsened because of development of a common cold, and the patient underwent an emergency tracheotomy. For anesthetic management, we used a combination of ketamine with low-concentration sevoflurane inhalation. The tracheotomy was performed safely without respiratory complications by employing manual-assisted ventilation, while spontaneous breathing was preserved by use of a face mask.

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Correspondence to Mami Ueda.

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Ueda, M., Okutani, R., Nakada, K. et al. Anesthetic management during tracheotomy in a child with respiratory distress caused by severe intubation-induced glottic stenosis. J Anesth 26, 449–452 (2012). https://doi.org/10.1007/s00540-012-1324-7

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  • DOI: https://doi.org/10.1007/s00540-012-1324-7

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