Dexmedetomidine for rigid bronchoscopy in an infant with tracheal web after ventricular septal defect patch repair

We report herein successful rigid bronchoscopy with preserved spontaneous breathing of a 54-day-old infant with tracheal web associated with previous ventricular septal defect (VSD) repair. We considered the use of dexmedetomidine in conjunction with intermittent ketamine from the following three clinical aspects. First, this infant was suffering from respiratory distress with chest retraction, the cause of which was not revealed by a computerized scan of the neck and chest. Second, the patient was scheduled for rigid bronchoscopy, which is accompanied by brief but strong stimulation. Third, this infant underwent congenital VSD heart repair approximately 1 month earlier.