Induction of anesthesia
Routine monitoring conducted after the patient entered the operation
room showed the following vital signs: heart rate, 88 beats/min; blood
pressure, 112/68 mmHg; respiration rate, 20 breaths/min; and oxygen
saturation (SpO2) level, 96%. Although awake fiberoptic intubation
would have been ideal, it is not preferred in a frightened child.
Initially, ketamine 10 mg and dexmedetomidine 10 µg were administered.
After preoxygenation for 5 min, local anesthetic topicalization of the
airway was followed by administration of lignocaine 10 mg and ephedrine
5 mg. Subsequently, successful intubation was achieved by fiberoptic
intubation bronchoscopy via the nasal route to find the glottis, and a
lubricated tracheal tube of internal diameter 5 mm was inserted through
the nostril to enter the trachea. The breathing circuit was attached
through an endotracheal tube connector, and adequate spontaneous
ventilation was ensured. Further anesthetics were administered
routinely, and the surgery proceeded smoothly with stable intraoperative
vital signs (Figure 3).
After 2 days in the intensive care unit, the extubation was performed
smoothly, and the patient was discharged to the rehabilitation ward with
SpO2 at 97%. The patient was discharged from the rehabilitation ward
after 8 days.