How is Anesthesia Used During Airway Surgery?
General anesthesia is given for evaluation of and reconstructive surgery on the airway. Common procedures are:
- Microlaryngoscopy (examination of the inside of the larynx or voice box)
- Bronchoscopy (examination of the bronchi, the two main branches going from the trachea to the lungs)
- Laryngotracheoplasty (surgery to correct a narrowed airway)
- Epiglottoplasty (repair of the epiglottis, which covers the larynx)
- Laser surgery
The most important issue for the anesthesiologist is how to best manage the pediatric airway. We tailor our services to address each child's individual needs.
Preparing Your Child for Surgery
Before the operation, your child will be assessed and prepared for surgery. You will be asked questions about your child's medical history, allergies, current medications, previous anesthetic experience and current health status. Your child's airway, heart and lungs will be examined carefully.
Our goal is for your child to feel safe and happy in our environment. A member of the nursing or child life department will explain, in a child-friendly manner, what the day will be like.
If extremely anxious, your child may be sedated with a medication taken by mouth, given intravenously (IV), or into the nose with an atomizer 10 to 15 minutes before going to sleep for surgery, if the anesthesiologist deems it safe and appropriate. This helps relax the child, makes separation from the parents smoother and often provides amnesia so the child does not remember the experience.
During Surgery
General anesthesia is usually given by having your child breathe anesthetic gas through a mask. Once they are asleep, an IV line is placed and anesthesia is usually maintained with inhaled gases.
Anesthesia professionals with pediatric subspecialty training will monitor your child closely during surgery. Routine equipment will check on the heart's electrical activity, blood pressure, oxygen levels in the blood and breathing (measuring inhaled oxygen and exhaled carbon dioxide concentrations). Pain medications are given during surgery as needed.
For reconstructive airway surgery, the airway is kept open by tracheostomy (if already present) or a breathing tube. For bronchoscopy, a breathing tube is not usually used. Instead, anesthesia is usually maintained by delivering anesthetic gases through the bronchoscope.
After Surgery
Children who have major airway reconstructive surgery are cared for in the Pediatric Intensive Care Unit after surgery.
For some procedures, children will need a breathing tube for seven to 10 days after surgery to support breathing. In order to ensure the child's comfort in these situations, your child will receive sedatives as well as IV pain medications.
