DIAGNOSTIC BRONCHOSCOPY FOR EVALUATION OF CONGENITAL STRIDOR:A CASE SERIES
نویسندگان
چکیده
Introduction: Stridor is a noise mechanically produced through partially occluded airway. Airway obstruction may be extrathoracic or intrathoracic. congenital acquired. Timing in respiratory cycle determines anatomic location of lesion – inspiratory, biphasic, expiratory. Gold standard for diagnosis bronchoscopy which requires general anaesthesia infants and small children. Major anaesthetic concerns are possible difficult airway, sharing an already compromised airway oedema. Case Description: 40 infants, 0 - 6 months age, with history noisy breathing suggestive stridor, planned diagnostic rigid without therapeutic procedure, over one year period. Preoperative treatment humidified oxygen, nebulization, dexamethasone, antibiotics, anti-reflux medication. Not premedicated, monitors applied. Induction inhalational oxygen sevoflurane intravenous propofol, fentanyl 1 mcg/kg, dexamethasone 0.5 mg/kg. Topical lidocaine 2% sprayed at vocal cords. 100% propofol infusion maintenance spontaneous ventilation via nasopharyngeal Patients requiring surgical intervention intubated using microcuffed endotracheal tube. observed post-operatively. If was inadequate, to control during recovery, extubated on restoration ventilation. After intervention, babies shifted ICU elective 48 hours. Discussion: On bronchoscopy, laryngomalacia the finding majority cases. Others had subglottic stenosis, tracheomalacia, vocal-cord paresis, laryngeal cyst. Out patients, 9 underwent procedure were electively ventilated, 26 resumed breathing, 2 patients delayed recovery severe chest retractions desaturations they managed accordingly. One baby aged diagnosed grade III stenosis desaturatedand tracheostomy done. Conclusion:Anaesthesia significant challenge. Rigid under multidisciplinary approach close cooperation between all team members.
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ژورنال
عنوان ژورنال: International journal of advanced research
سال: 2021
ISSN: ['2707-7802', '2707-7810']
DOI: https://doi.org/10.21474/ijar01/13910