Journal article
Dynamic vocal cord behavior and stridor during emergence from general anesthesia in small children with supraglottic airway
Journal of anesthesia, Vol.37(5), pp.672-680
10/01/2023
DOI: 10.1007/s00540-023-03218-z
PMID: 37326855
Abstract
Purpose Stridor during emergence from anesthesia is not rare in children managed with supraglottic airway (SGA). However, we know little about the mechanisms of stridor and behavior of the vocal cords (VC). This study aimed to clarify patterns of VC movement and laryngeal airway maintenance function during recovery from anesthesia in children with SGA.Methods This is a secondary analysis of data collected from an observational study involving 27 anesthetized children. Using a multi-panel recording system, endoscopic VC image, vital sign monitor, multi-channel tracings of respiratory variables and respiratory sound and patient's view were simultaneously captured in one monitor. Inspiratory and expiratory VC angles formed by lines connecting anterior and posterior commissures were measured at the first spontaneous breath and the breath one minute after the first breath. VC narrowing and dilation were assessed by differences of VC angles.Results Inspiratory VC narrowing (median (IQR): 5.3 (2.7, 9.1) degree at the first breath) and dilation (- 2.7 (- 3.8, - 1.7) degree at the first breath) were observed in 15 and 12 out of 27 children, respectively. The former group achieved greater tidal volume compared to the latter in one minute. Five children (19%) temporarily developed stridor-like sound from outside with inspiratory VC narrowing. The stridor-like sound was captured by microphones attached to the neck and anesthesia circuit, but was not evident from the chest.Conclusion Laryngeal narrowing occurs in half of the children with SGA during emergence from anesthesia, and temporal stridor-like sound is relatively common.
Details
- Title: Subtitle
- Dynamic vocal cord behavior and stridor during emergence from general anesthesia in small children with supraglottic airway
- Creators
- Katsuhiko Ishibashi - Chiba University HospitalYuji Kitamura - Chiba University HospitalShinichiro Kato - Chiba University HospitalMiri Sugano - Chiba University HospitalYuichi Sakaguchi - Chiba University HospitalYasunori Sato - Keio UniversityShiroh Isono - Chiba University
- Resource Type
- Journal article
- Publication Details
- Journal of anesthesia, Vol.37(5), pp.672-680
- DOI
- 10.1007/s00540-023-03218-z
- PMID
- 37326855
- NLM abbreviation
- J Anesth
- ISSN
- 0913-8668
- eISSN
- 1438-8359
- Publisher
- Springer Nature
- Number of pages
- 9
- Grant note
- 17K16722; 20K17830 / Japan Society for the Promotion of Science; Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT)
- Language
- English
- Date published
- 10/01/2023
- Academic Unit
- Anesthesia
- Record Identifier
- 9985090698502771
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