The problems of anaesthesia for laryngoscopy and microlaryngeal surgery in children are discussed. The author's current techniques are described. For laryngoscopy, deep inhalational anaesthesia with halothane, combined with the topical application of lignocaine, is most commonly used. Microlaryngeal surgery may be performed using a pharyngeal insufflation technique to give unobstructed surgical access to the larynx. In other cases, tracheal intubation is acceptable to the surgeon, and may be used with spontaneous respiration or with muscle paralysis and controlled ventilation. Other methods, past and present, are reviewed.
References
1.
AlbertS. N., ShibuyaJ., and AlbertC. A. (1972): “Ventilation with an oxygen injector for suspension laryngoscopy under general anaesthesia”, Anesthesia and Analgesia, 51, 866.
2.
BenjaminB., and LinesV. (1972): “Endoscopy and anaesthesia in non-infective airway obstruction in children”, Anaesthesia, 27, 283.
3.
BennettE. J., TsuchiyaT., and StephenC. R. (1969): “Stridor and upper airway obstruction in infants”, Anesthesia and Analgesia, 48, 75.
4.
BromfieldD. H., and CullingfordD. W. J. (1972): “Anaesthesia for laryngeal microsurgery”, Anaesthesia, 27, 215.
5.
BrownT. C. K. (1970): “Gammahydroxybutyrate in paediatric anaesthesia”, Aust. N. Z. J. Surg., 40, 94.
6.
BrownT. C. K. (1972): “The Venturi bronchoscopic attachment—Paediatric considerations”, Anaesthesia and Intensive Care, 1, 54.
7.
BrownT. C. K. (1973): “Bronchoscopy for removal of foreign bodies in children”, Anaesthesia and Intensive Care (in press).
8.
BushG. H. (1973): Personal communication.
9.
CardenE., TrappW. G., and OultonJ. (1970): “A new and simple method for ventilating patients undergoing bronchoscopy”, Anesthesiology, 33, 454.
10.
CassN. M., and WaldieI. A. (1964): “A robust reliable throat spray”, Brit. J. Anaesth., 36, 61.
11.
FitzsimmonsJ. S. (1965): “Laryngeal stridor and respiratory obstruction associated with meningomyelocele”, Arch. Dis. Childh., 40, 687.
12.
GordonM., and SellarsS. (1971): “Anaesthesia for microsurgery of the larynx”, Anaesthesia, 26, 199.
13.
HerronR. A. C. (1950): “Anaesthetic adaptor for a bronchoscope”, Anaesthesia, 5, 40.
14.
KomesaroffD., and McKieB. (1972): “The ‘Bronchoflator’: A new technique for bronchoscopy under general anaesthesia”, Brit. J. Anaesth., 44, 1057.
15.
LeeS. T. (1972): “A ventilating laryngoscope for inhalation anaesthesia and augmented ventilation during laryngoscopic procedures”, Brit. J. Anaesth., 44, 874.
16.
OultonJ. L., and DonaldD. M. (1971): “A ventilating laryngoscope”, Anesthesiology, 35, 540.
17.
PollardB. J. (1968): “Anaesthesia for laryngeal microsurgery”, Anaesthesia, 23, 534.
18.
RajagopalanR., SmithF., and RamachandranP. R. (1972): “Anaesthesia for microlaryngoscopy and definitive surgery”, Canad. Anaesth. Soc. J., 19, 83.
SandersR. D. (1967): “Two ventilating attachments for bronchoscopes”, Delaware Med. J., 39, 170.
21.
Steglich-PetersenJ. (1967): “Controlled respiration through a ventilating bronchoscope”, Acta anaesth. Scandinav., 2, 261.
22.
WickramasingheS. F., EcksteinH. B., and NixonH. H. (1967): “Posterior fossa decompression in shunt-treated hydrocephalic children”, Dev. Med. and Child Neurology, Supp. 15, II.
