Wang Lei,Wang Shaochao,Hu Weidong,et al.Application of laryngeal mask general anesthesia in pediatric percutaneous dilatational tracheostomy guided by fiberbronchoscope[J].Journal of Clinical Pediatric Surgery,2025,(02):172-178.[doi:10.3760/cma.j.cn101785-202410045-012]
Application of laryngeal mask general anesthesia in pediatric percutaneous dilatational tracheostomy guided by fiberbronchoscope
- Keywords:
- Laryngeal Mask Airway; Anesthesia; General; Fiberbronchoscope; Percutaneous Dilatational Tracheostomy; Child
- Abstract:
- Objective To explore the efficacy of laryngeal mask general anesthesia during percutaneous dilatational tracheostomy guided by fiberbronchoscope in children. Methods Retrospective analysis of medical records was performed for 40 hospitalized children undergoing percutaneous dilatational tracheostomy at Affiliated Children’s Hospital of Shandong University from June 2019 to September 2023.Preoperative ultrasonic assessment was performed for evaluating thyroid position and following the course of anterior tracheal vessels.This aided in selecting an appropriate puncture route and marking the puncture point.After general anesthesia,a laryngeal mask was utilized for respiratory control to ensure ventilation and percutaneous dilatational tracheotomy performed guided by fiberbronchoscope after successful laryngeal mask placement.Statistical analyses were conducted for general profiles,anesthesia protocols,ventilation mode,surgical procedures,vital signs and adverse events. Results All procedures were performed smoothly and safely.The average surgical duration was (35±9) min and average anesthesia duration (41±9) min.Laryngeal masks were all successfully placed and pressure controlled breathing was achieved with peak inspiratory pressures of (12-20) cmH2O.There was a variable elevation in airway pressure and a slight declined in tidal volume during flexible bronchoscopy.Vital signs remained stable.The incidence of adverse events during perioperative period was 15%.It was primarily attributed to gastrointestinal distension and hypoxemia. Conclusions Pediatric percutaneous dilatational tracheostomy presents a high risk in terms of perioperative anesthesia management.Laryngeal mask ventilation under general anesthesia can effectively provide ventilation and maintain a stable depth of anesthesia.This approach ensures a smooth progression of the procedure while maintaining the stability of vital signs.It enhances the operative safety and is worthy of wider clinical applications.
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Memo
收稿日期:2024-10-18。
基金项目:济南市卫生健康委员会科技计划项目(2023-2-152)
通讯作者:王少超,Email:330876630@qq.com