Airway management is one of the most important aspects of pediatric anesthesia because of its inextricable relationship to the most important complication – the development of hypoxemia. This importance is further exemplified by the inherent differences in pediatric airway management when compared with adults. This chapter reviews the basics of pediatric airway management, with an emphasis on t...

Lymphangioma is a congenital malformation of the lymphatic system, often involving areas of the head and neck. Patients may require surgical excision. Anaesthetic concerns include bleeding, difficulty visualising the airway, extrinsic and intrinsic pressure on the airway causing distortion, and enlarged upper respiratory structures, including the lips, tongue and epiglottis, which make airway m...

A retrospective analysis of the records of about 9,000 intravenous anaesthetics showed a striking relationship between dosage and induction complications. While the incidence of excitatory phenomena increased with dosage of thiobarbiturates, this effect was more marked with methylated barbiturates. The greater frequency of respiratory complications (cough, hiccough and laryngospasm) with high d...

The receptor sites and nerve pathways involved in the reflex production of laryngospasm have been investigated in the cat. The trigeminal nerves and the internal branch of the superior laryngeal nerves were shown to provide an afferent pathway for the reflex when the nasopharynx and larynx were exposed to ether vapour. Evidence was obtained suggesting that the recurrent laryngeal nerves may for...

The clinical syndrome of aspirin-exacerbated respiratory disease (AERD) is a condition where inhibition of cyclooxygenase-1 (COX-1) induces attacks of upper and lower airway reactions, including rhinorrhea and varying degrees of bronchospasm and laryngospasm. Although the reaction is not IgE-mediated, patients can also present with anaphylactic hypersensitivity reactions, including hypotension,...

Gastroesophageal reflux (GER) is a common problem in infants and children. Physiologic vomiting is common in the first 6 months to 1 year of life. However, pathologic gastroesophageal reflux disease (GERD) can present in childhood. Pathologic GERD is the occurrence of reflux with associated complications that can include failure to thrive, aspiration, laryngospasm, and esophagitis.1 Treatment o...

Using a fibreoptic laryngoscope, we have recorded on video tape the movements of the vocal cords after induction of anaesthesia with either propofol or thiopentone. The angle formed by the vocal cords decreased after induction of anaesthesia in both groups. This reduction in angle was significantly greater in the thiopentone group. The vocal cords closed completely in four patients in the thiop...