Abstract
Purpose
To detail our experience using dexmedetomidine in combination with propofol for airway foreign body removal in spontaneously breathing patients.
Clinical features
Dexmedetomidine and propofol intravenous anesthesia as a primary anesthetic was used for three pediatric patients with severe respiratory impairment due to foreign body aspiration and two elderly patients requiring airway foreign body removal by rigid bronchoscopy. All patients were spontaneously ventilating, and had successful airway foreign body removal without severe hypoxemia. The three pediatric patients maintained stable respiratory and hemodynamic profiles. However, dexmedetomidine caused a significant change in the hemodynamics of the elderly patients.
Conclusion
Dexmedetomidine and propofol intravenous anesthesia provided good anesthesia without causing respiratory depression. However, this technique related to more hemodynamic depression in elderly patients than in pediatrics.
References
Patel A, Davidson M, Tran MC et al (2010) Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg 111:1004–1010
Seybold J, Ramamurthi RJ, Hammer GB (2007) The use of dexmedetomidine during laryngoscopy, bronchoscopy, and tracheal extubation following tracheal reconstruction. Pediatr Anesth 17:1212–1214
Silver AL, Yager P, Purohit P et al (2011) Dexmedetomidine use in pediatric airway reconstruction. Otolaryngol–Head Neck Surg 144:262–267
Shukry M, Kennedy K (2007) Dexmedetomidine as a total intravenous anesthetic in infants. Pediatr Anesth 17:581–583
Ramsay MA, Luterman DL (2004) Dexmedetomidine as a total intravenous anesthetic agent. Anesthesiol 101:787–790
Shah RK, Patel A, Lander L (2010) Obstructing the airway in children: management of foreign bodies. Arch Otolaryngol Head Neck Surg 136:373–379
Shen X, Hu CB, Ye M et al (2012) Propofol-remifentanil intravenous anesthesia and spontaneous ventilation for airway foreign body removal in children with preoperative respiratory impairment. Pediatr Anesth 22:1166–1170
Oberer C, von Ungern-Sternberg BS, Frei FJ et al (2005) Respiratory reflex responses of the larynx differ between sevoflurane and propofol in pediatric patients. Anesthesiology 103:1142–1148
Koroglu A, Teksan H, Sagir O et al (2006) A comparison of the sedative, hemodynamic and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesth Analg 103:63–67
Mason KP, Zurakowski D, Zgleszewski SE et al (2008) High dose dexmedetomidine as the sole sedative agent for pediatric MRI. Pediatr Anesth 18:403–411
Pasin L, Greco T, Feltracco P et al (2013) Dexmedetomidine as a sedative agent in critically ill patients: a meta-anlysis of randomized controlled trials. PLoS One 8:e82913
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Chen, K., Shen, X. Dexmedetomidine and propofol total intravenous anesthesia for airway foreign body removal. Ir J Med Sci 183, 481–484 (2014). https://doi.org/10.1007/s11845-014-1105-4
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DOI: https://doi.org/10.1007/s11845-014-1105-4