Anesthetic management for an infant undergoing endoscopic resection of a large subglottic papiloma

BACKGROUND: An infant with a large subglottic papilloma that caused severe respiratory distress needed anesthesia during resection of the papilloma. AIMS: We planned an approach to the airway management this infant that we thought would be successful. METHODS: We used three main tactics in managing the airway – inhaled sevoflurane, intravenous fentanyl and the patient's resumed spontaneous breathing. We also allowed the otolaryngologist to quickly resect some of the papilloma before intubation. RESULTS: Our patient's airway was managed successfully, and the papilloma was removed. CONCLUSIONS: Management of the airway in a small child with obstruction can be aided by inducing anesthesia with sevoflurane, deepening anesthesia with intravenous fentanyl, and allowing the patient to resume spontaneous breathing.