Pediatric Airway Management

Fiadjoe, John E.; Stricker, Paul A.; Litman, Ronald S.

doi:10.1002/9781119371533.ch16

Cited by 2 publications

(2 citation statements)

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“…The importance of maintaining adequate oxygenation during airway management is unquestioned and is explicitly stated in Gregory's Pediatric Anesthesia textbook. 6 Compared to adults, children undergoing mask induction of anesthesia have proportionally less FRC, higher oxygen consumption per kilogram, an elevated risk of laryngospasm, and are without intravenous access. Because of these factors, a laryngospasm that occurs in the presence of 70% nitrous oxide will cause a more rapid and profound desaturation 2 than if the child had been pre-oxygenated during induction.…”

Section: Re a Son: B Ec Aus E We Have Always Done It This Waymentioning

confidence: 99%

“…Preoxygenation prior to induction is a basic tenet of anesthesia practice used to increase the margin of safety for patients in our care. The importance of maintaining adequate oxygenation during airway management is unquestioned and is explicitly stated in Gregory's Pediatric Anesthesia textbook 6 . Compared to adults, children undergoing mask induction of anesthesia have proportionally less FRC, higher oxygen consumption per kilogram, an elevated risk of laryngospasm, and are without intravenous access.…”

Section: Reason: Because We Have Always Done It This Waymentioning

confidence: 99%

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It's time to stop using nitrous oxide for pediatric mask induction

Gordon,

Chatterjee,

McGain

2023

Pediatric Anesthesia

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BackgroundMask induction of anesthesia for pediatric patients has included the use of nitrous oxide since the inception of pediatric anesthesia. However, the use of nitrous oxide precludes adequate preoxygenation. Additionally, pediatric physiology (less Functional Residual Capacity, higher oxygen consumption), increased risk of laryngospasm and lack of intravenous access increase the risk of a severe airway complication in the event of airway occlusion. Nitrous oxide does not facilitate tranquil mask placement on an unwilling child and does not meaningfully speed mask induction. Exposure to nitrous oxide has potential occupational health concerns and nitrous oxide has significant environmental detriment.ConclusionUtilizing other, evidence‐based, techniques to facilitate tranquil mask placement will assure that patients have a pleasant induction experience and avoiding nitrous oxide will reduce the environmental impact, as well as improve the safety of, pediatric mask induction.

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Section: Re a Son: B Ec Aus E We Have Always Done It This Waymentioning

confidence: 99%

Section: Reason: Because We Have Always Done It This Waymentioning

confidence: 99%