Dexmedetomidine and proprofol in complex microlaryngeal surgery in infants

We describe the case of an infant undergoing endoscopic repair of a laryngeal cleft where the combination of dexmedetomidine and propofol infusions was used as the anesthetic technique. With this regimen, endotracheal intubation was unnecessary during the perioperative period, the procedure lasted approximately 3h, and the child recovered uneventfully. Historically, the techniques used for microlaryngeal surgery involve the use of intermittent endotracheal intubation and insufflation of halogenated anesthetics to the oropharynx. Given the potential benefits of a technique that obviates the need for endotracheal intubation during microlaryngeal surgery and prevents insufflation of halogenated anesthetics in an open environment, the combination of propofol and dexmedetomidine should be considered as a viable and desirable anesthetic option for infants undergoing complex microlaryngeal surgery.