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Published on: January 17, 2011
Ventilation with facial mask in the prone position for radiotherapy procedures in children
A Perez-Ferrer1, E Gredilla-Díaz1, J de Vicente-Sánchez1
1Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
Insights
This study shows a new prototype for pediatric facial mask ventilation in the prone position is safe and effective. It allows for minimally invasive airway management and supports early hospital discharge.
Area of Science:
- Anesthesiology
- Pediatric Oncology
- Medical Device Development
Background:
- Ventilating pediatric patients in the prone position without tracheal intubation poses challenges for anesthesiologists.
- Minimally invasive airway management is crucial for procedures like radiotherapy in children.
Purpose of the Study:
- To evaluate the effectiveness and safety of a novel prototype for pediatric facial mask ventilation in the prone position.
- To assess the feasibility of this technique for radiotherapy sessions in young children.
Main Methods:
- A prospective descriptive study involving 105 sedations in 3 pediatric patients undergoing radiotherapy.
- Sedation was induced and maintained with sevoflurane in oxygen, with spontaneous ventilation.
- A custom prototype using expanded polystyrene (EPS) secured the facial mask and immobilized the head in the prone position.
Main Results:
- All sedations were successfully completed as planned.
- Patients maintained oxygen saturation above 95% without any reported complications.
- The average length of hospital stay, including the procedure and recovery, was 54.4±7.9 minutes.
Conclusions:
- The developed prototype and sedation technique are effective and safe for pediatric facial mask ventilation in the prone position.
- This approach enables secure airway management, adequate ventilation, and light sedation during radiotherapy, facilitating early discharge.
Objectives:
Ventilation of patients undergoing procedures in the prone position represents a challenge for the anesthesiologist, especially when trying to avoid tracheal intubation. This study aimed to test the effectiveness and safety of a prototype designed for pediatric facial mask ventilation in the prone position.
Material And Methods:
A prospective descriptive study was conducted on 105 sedations performed in 3 children scheduled for radiotherapy treatment of posterior fossa desmoplastic medulloblastoma (6 and 4 y.o. males), and neuroblastoma in temporal area (4 y.o. male). Induction and maintenance of sedation were conducted with sevoflurane in oxygen, maintaining spontaneous ventilation. After achieving loss of consciousness and immobility, the patients were placed in the prone position. Their heads were fixed with the forehead and face supported by a prototype made with a cast of expanded polystyrene (EPS), which held the facial mask (connected to a Mapleson D circuit), and the back of the head immobilized with a layer of thermoplastic material. Time variables and complications were recorded.
Results:
All sedations were performed according to the planned protocol. All patients maintained oxygen saturation levels above 95%, and no complications were reported. Daily hospital length of stay including the procedure and post anesthetic recovery was 54.4±7.9 min (mean±SD).
Conclusions:
The prototype and the sedation technique with face mask in the prone position employed were effective and safe, allowing the completion of the radiotherapy sessions and securing the airway in a minimally invasive way, maintaining adequate ventilation, light sedation and enabling early hospital discharge.
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