Halothane Sedation with Local Anesthesia as a Bailout Procedure for Neonate with Subglottic Stenosis and Post-MMC Repair Defect for O-Z Flap: A Case Report

Abstract

Mikael Aseged Shimekit, Zemed Geleta Eshetie, and Mahelt Getachew Lemma

Introduction Subglottic stenosis (SGS) can develop after intubation in children. With mild subglottic stenosis, children can be asymptomatic. Endotracheal intubation is difficult in infants with subglottic stenosis. Here is a case of subglottic stenosis in an infant planned for flap wound closure managed with sedation.

Case Presentation A 1-month-old infant for whom thoracolumbar myelomeningocele (MMC) was repaired during her 2nd week of life, then she developed a wound infection on the 4th postoperative day, and after 2 weeks she was scheduled for a wound closure. However, intubation was difficult and rescheduled but with the senior anesthesiologist, it was not possible to intubate, and after discussion with an anesthesiologist sedation and local anesthesia were used to proceed with wound closure with a flap.

Conclusion Sedation with local anesthesia can be used for neonates and infants with subglottic stenosis when intubation is difficult.

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