Ear, Nose and Throat Tests and Procedures

Anesthesia for Airway Surgery

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Explanation | Before the operation | During the operation | After the operation | Contact us

What is anesthesia for airway surgery?

Cincinnati Children's Hospital Medical Center is one of the premier centers for management of children with airway problems. Our patients come from all over the United States as well as from foreign countries to receive medical care.

A highly skilled, experienced multidisciplinary team will provide expert care for your child. Members include surgeons, gastrointestinal and pulmonary physicians, anesthesiologists, nurse anesthetists and nurses in the same day surgery unit, operating room and Post Anesthesia Care Unit (PACU). They all work together to provide the highest quality care for your child.

We pride ourselves on providing family-centered, safe and effective care, no matter how complex your child's medical problems.

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 difficult airway. We tailor our services to address each child's individual needs.

Before the operation

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 or given intravenously (IV), 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 the operation

General anesthesia is usually given by having your child breathe anesthetic gas through a mask. Once the child is asleep, anesthesia is usually maintained with inhaled gases.

Anesthesia professionals 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 the operation

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 ten days after surgery to help with breathing. In order to ensure the child's comfort in these situations, your child will receive sedatives as well as IV pain medications.