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Upper airway collapsibility in anesthetized children.

Ronald S Litman1, Joseph M McDonough, Carole L Marcus

  • 1Department of Anesthesiology, University of Rochester, Rochester, New York, USA. Litmanr@email.chop.edu

Anesthesia and Analgesia
|February 24, 2006
PubMed
Summary

This study found halothane causes less upper airway obstruction than sevoflurane in anesthetized children. Dynamic negative airway pressure effectively measured airway collapsibility in pediatric patients.

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Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Respiratory Physiology

Background:

  • Assessing upper airway narrowing in spontaneously breathing, anesthetized children is challenging.
  • Understanding the effects of different anesthetic agents on airway collapsibility is crucial for patient safety.

Purpose of the Study:

  • To determine the feasibility of measuring upper airway narrowing in pediatric patients using dynamic negative airway pressure.
  • To compare upper airway collapsibility differences between sevoflurane and halothane at equipotent concentrations.

Main Methods:

  • Children undergoing anesthesia were randomized to receive either sevoflurane or halothane.
  • Dynamic negative airway pressure was applied to induce partial upper airway obstruction.
  • Critical closing pressure (Pcrit) of the pharynx was calculated by plotting inspiratory flow against negative pressure.

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Main Results:

  • Halothane was associated with significantly less upper airway obstruction compared to sevoflurane (P = 0.048).
  • Mean Pcrit for sevoflurane was -9.8 +/- 1.9 cm H2O, while for halothane it was -19.4 +/- 9.3 cm H2O.
  • The method of dynamic negative airway pressure proved feasible for assessing airway collapsibility.

Conclusions:

  • Halothane appears to induce less upper airway obstruction than sevoflurane at equipotent concentrations in pediatric anesthesia.
  • Dynamic negative airway pressure is a viable technique for evaluating upper airway collapsibility in spontaneously breathing, anesthetized children.