Experience with dexmedetomidine in pediatric tubeless anesthesia for endoscopic airway surgery: A report of three cases

Abstract

Airway surgeries in children are very challenging to the anesthesiologist because of the nature of the
surgeries as well as the unique characteristics of the patient population involved. While the surgeon wants
a ‘free and uninterrupted field’ for ease of access, the anesthetist has to ensure continuous oxygenation
and ventilation to a patient whose respiratory dynamics are very volatile. The challenges are compounded
by the factor of the shared airway. Dexmedetomidine has emerged as a popular anesthetic agent in various
settings. However, there are not many reports of its use in children for endoscopic airway surgeries as an
anesthetic. The main reason limiting use of dexmedetomidine in children is its common side effects of
bradycardia and hypotension, of which bradycardia can be critical in this age group.
We describe our experience with using dexmedetomidine for spontaneous respiration anesthesia in
three children undergoing complex endoscopic airway surgeries.