ABSTRACT

Inhalation induction and maintanance of anesthesia with spontaneous ventilation in the child with a difficult airway offer many advantages. We presented three pediatric patients with a difficult airway where sevoflurane was used as the induction agent and fibreoptic intubation.

Patient no I: A 5-month old female patient with cleft lip and plate is presented for cleft lip repair. Conventional oral intubation was failed.

Patient no II: A 10-year old male patient with submandibular abcess is presented for the abcess drain. He had been diagnosed as having osteopetrosis at the age of 12 months. He had spontaneous servical fracture.

Patient no III: A 5-year old male patient with strabismus is presented for recession and resection. He had growth restriction with macroglossi. Therefore, we prefered to perform inhalational induction with sevoflurane and fiberoptik intubation for all patients. Anesthesia induction was accomplished with sevoflurane in oxygen. We succeeded in intubation of the patient no I and the patient no III in first attempt and the patient no II in second attempt by using fiberoptik bronchoscope.

Sevoflurane is low blood gas solubility in combination with minimal airway irritation allows for smooth and rapid induction for anaesthesia. Rapid emergence from anesthesia with sevoflurane might confer benefit in a critical istuation. As a result, fiberoptic intubation while maintaining spontaneous breathing under inhaled sevoflurane anesthesia is a safe method of securing the airway in pediatric patients who had difficult airway.