1991
Nasal RAM cannulae for breathing support and inhalation anaesthesia in infants during videolaryngoscopy.
Anaesthetic techniques,inhalation, Anaesthetic techniques,laryngoscopy, Infants
A. Piotrowski, T. Oleniacz, T. Grochowski, Sz. Nalepa. Children's Memorial Health Institute - Warsaw (Poland)
Background and Goal of Study: The safe anesthesia for direct laryngoscopy requires sufficient oxygen and ventilation support during the procedure with no collision with otolaryngologist. The use of nasal continuous positive airway pressure (CPAP) may be advantageous, especially in patients with respiratory problems. The RAM device, invented for nasal support of ventilation attached to an anaesthesia machine can provide both CPAP and delivery of sevoflurane.
Materials and Methods:In 5 infants and 1 child with stridor and/or unsuccessful extubation direct laryngoscopy was undertaken. Patients were anaesthetized with a combination of sevoflurane in air/oxygen and boluses of i.v. propofol. For maintenance of anesthesia and ventilation assistance nasal RAM cannuale were used. Nasal CPAP technique was tried, manual breaths given when required.
Results and Discussion: Infants with weight from 3,0 to 8,0 kg were successfully anesthetized with inahalation of sevoflurane, only 2 out required i.v. doses of propofol. Paracetamol and fentanyl (0,5 mcg/kg) were used for analgesia. In one case i.v. lidocaine was also administered. After induction sevoflurane (1,0 -1,5
MAC) was delivered through the RAM cannulae. There was an efficient anaesthesia level and proper gas exchange during procedures. This method of delivery of anaesthetic mixture was very practical in an opinion of otolaryngologists. Two out of 3 intubated patients could be extubated and remained on nasal CPAP
afterwards.
Conclusion(:The use of RAM nasal cannulae is useful for gas and sevoflurane delivery during direct video laryngoscopy.
References :Nzegwu NI, Mack T, DellaVentura R et al. Systematic use of the RAM nasal cannula in the Yale-New Haven Children's Hospital Neonatal Intensive Care Unit: a quality improvement. project. J Matern Fetal Neonatal Med. 2015;28:718-21

09 / Nasal RAM cannulae for breathing support and inhalation anaesthesia in infants during laryngoscopy.