Related Experiment Video

Updated: Apr 9, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

18.9K

General Anesthetic Exposure in the Management of Pediatric Subglottic Stenosis

Kevin Koss1, Marvin S Lu2, Logan Massman3

  • 1Department of Otolaryngology and Communication Sciences Medical College of Wisconsin Milwaukee Wisconsin USA.

World Journal of Otorhinolaryngology - Head and Neck Surgery
|April 8, 2026
PubMed

Insights

Children with subglottic stenosis (SGS) undergoing laryngotracheal reconstruction (LTR) had more anesthesia and procedures than those treated with endoscopic balloon dilation (EBD). This highlights the importance of discussing anesthesia risks with parents.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Anesthesiology
  • Airway Reconstruction

Background:

  • Subglottic stenosis (SGS) is a rare but serious condition in children.
  • Treatment options for SGS include endoscopic balloon dilation (EBD) and laryngotracheal reconstruction (LTR).
  • General anesthesia (GA) exposure in early childhood is a growing concern due to potential neurocognitive effects.

Purpose of the Study:

  • To compare the total time spent under general anesthesia (GA) and the number of procedures required for treating pediatric subglottic stenosis (SGS).
  • To evaluate the impact of different treatment modalities, specifically EBD versus LTR, on anesthesia exposure and procedural burden.
  • To analyze the relationship between SGS severity and treatment-associated anesthesia and procedures.

Main Methods:

  • Retrospective review of 31 children with SGS treated between November 2014 and August 2020.
  • Inclusion criteria included a completed treatment course (12 months without airway intervention).
  • Data collected included age at first procedure, treatment modality (EBD, LTR, or both), total GA hours, and number of procedures.

Main Results:

  • Children undergoing LTR (n=13) received significantly more GA (17.1 ± 7.9 hours) and procedures (11.1 ± 4.9) compared to EBD alone (n=18; 6.2 ± 3.0 hours; 5.9 ± 3.5 procedures).
  • Each EBD procedure added 0.96 hours of anesthesia, while each LTR procedure added 7.0 hours.
  • Both GA exposure and procedure count increased with higher grades of SGS.

Conclusions:

  • Laryngotracheal reconstruction (LTR) is associated with a substantial increase in general anesthesia (GA) exposure and procedural burden compared to endoscopic balloon dilation (EBD) for subglottic stenosis (SGS).
  • While anesthesia exposure may not solely dictate treatment choice, it is a critical factor for parental counseling due to potential neurocognitive risks.
  • SGS severity directly correlates with increased anesthesia exposure and the number of interventions required.
Abstract

Keywords:
anesthesiaballoon dilationlaryngotracheal reconstructionsubglottic stenosis

More Related Videos

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

2.6K
In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells04:56

In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells

Published on: October 23, 2018

7.1K

Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
1.0K
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
1.6K
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
946
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
2.4K
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
1.2K
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
1.9K