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Updated: May 21, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Anesthetic management for an infant undergoing endoscopic resection of a large subglottic papiloma
1Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
Insights
Anesthesia for infant airway obstruction due to subglottic papilloma was successfully managed using inhaled sevoflurane, intravenous fentanyl, and spontaneous breathing. This approach facilitated safe papilloma resection.
Area of Science:
- Pediatric Anesthesiology
- Airway Management
- Surgical Oncology
Background:
- Infantile subglottic papilloma presents a significant airway obstruction risk.
- Severe respiratory distress necessitates prompt surgical intervention.
Background:
An infant with a large subglottic papilloma that caused severe respiratory distress needed anesthesia during resection of the papilloma.
Aims:
We planned an approach to the airway management this infant that we thought would be successful.
Methods:
We used three main tactics in managing the airway - inhaled sevoflurane, intravenous fentanyl and the patient's resumed spontaneous breathing. We also allowed the otolaryngologist to quickly resect some of the papilloma before intubation.
Results:
Our patient's airway was managed successfully, and the papilloma was removed.
Conclusions:
Management of the airway in a small child with obstruction can be aided by inducing anesthesia with sevoflurane, deepening anesthesia with intravenous fentanyl, and allowing the patient to resume spontaneous breathing.
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