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Propofol–remifentanil intravenous anesthesia and spontaneous ventilation for airway foreign body removal in children with preoperative respiratory impairment
Author(s) -
Shen Xia,
Hu ChunBo,
Ye Min,
Chen YingZi
Publication year - 2012
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2012.03899.x
Subject(s) - medicine , remifentanil , anesthesia , propofol , respiratory rate , pacu , laryngospasm , ventilation (architecture) , pulse oximetry , heart rate , airway , blood pressure , mechanical engineering , engineering
Summary Purpose: To investigate the efficacy and safety of propofol–remifentanil total intravenous anesthesia (TIVA) and spontaneous ventilation for foreign body (FB) removal in pediatric patients with preoperative respiratory impairment. Methods: We 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 (SpO 2 ), respiratory rate, endtidal CO 2 (ETCO 2 ) , induction time, and remifentanil rate were recorded. Adverse events, the intervention for these events, and the duration of postoperative care were also of interest. Results: Sixty children completed the study. The mean induction time was 12.3 min. During the procedure, the maximum remifentanil rate was 0.14 μg·kg −1 ·min −1 . Light breath holding occurred in 16 (26.7%) patients. No severe breath holding or body movements were observed. An SpO 2 below 90% occurred in 10 (16.7%) cases. No progressive desaturation was observed. The mean ETCO 2 at the end of the procedures was 7.91 KPa and returned to normal 5 min after the procedure. In the postanesthesia care unit (PACU), no hypoxemia was observed and the mean recovery time was 23.4 min. No laryngospasm, pneumothorax, or arrhythmias were observed. Conclusion: Propofol–remifentanil TIVA and spontaneous ventilation are effective and safe techniques to manage anesthesia during airway FB removal in children with preoperative respiratory impairment.