Anesthesia for laryngeal laser surgery in the infant and child

Currently available anesthetic techniques for laryngoscopy and bronchoscopy are briefly evaluated. Recently reported complications from the literature are reviewed. Satisfactory anesthetic techniques are shown to be limited by the physical dimensions of the instruments as well as the extreme limitations of the flow capacity of the small airway itself. The technique used at the Hospital for Sick Children for the past ten years is described. It is based upon spontaneous respiration with inhalation anesthesia, supplemented by topical lidocaine (Xylocaine). Size and age of the patient are not limiting factors. The safety and effectiveness of this technique are supported by representative blood gas studies as well as the clinical records of over 400 cases.