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Case Report

Anaesthetic Management of an Infant with Laryngeomalacia and CHD Scheduled for Rigid Tracheobronchoscopy

Ravi Madhusudhana , Ishita Raj 1 , Ravi Madhusudhana 2

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Indian Journal of Anesthesia and Analgesia 8(4):p 23-26, July-August 2021. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8421.64

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Ishita Raj, Ravi Madhusudhana/Anaesthetic Management of an Infant with Laryngeomalacia and CHD Scheduled for Rigid Tracheobronchoscopy/Indian J Anesth Analg. 2021; 8(4): 441-443.

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Abstract

Introduction: Laryngomalacia is defined as collapse of supraglottic structures during inspiration. It is the most common laryngeal disease of infancy and cause of stridor in newborns. Case Report: A 17 days old child (2.75kgs) with congential laryngomalacia was scheduled for rigid tracheobronchoscopy. Child had a history of recurrent lower respiratory tract infection which resolved with intravenous antibiotics and steroids. On auscultation he had no adventitious sounds when quiet but added sounds were heard when he cried. Echocardiography showed CHD with situs solitus levocardia with 4mm ASD and 2mm PDA with dilated RA/RV. The child was administered atropine, midazolam, atracurium and ketamine. Maintainence with sevoflurane . During rigid bronchoscopy we provided adequate analgesia and sedation without clinically significant hemodynamic or respiratory adverse effects. Conclusion: In summary we noted that ketamine provided a reliable and effective method of sedating infants undergoing a rigid bronchoscopic examination in spontaneous ventilating conditions and noted no clinically significant haemodynamic or respiratory problems. When these patients do present, their care is likely to be complex and challenging. As such , a multidisciplinary approach should be adopted throughout their period of care.

 

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Ishita Raj, Ravi Madhusudhana/Anaesthetic Management of an Infant with Laryngeomalacia and CHD Scheduled for Rigid Tracheobronchoscopy/Indian J Anesth Analg. 2021; 8(4): 441-443.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8421.64

Keywords

Congenital heart disease; Laryngomalacia; Tracheobronchoscopy.

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