Department of Anesthesia, BC Children's Hospital, Vancouver, Canada.
Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, Canada.
Paediatr Anaesth. 2020 Mar;30(3):209-220. doi: 10.1111/pan.13809. Epub 2020 Jan 27.
Anesthesia for pediatric airway procedures constitutes a true art form that requires training and experience. Communication between anesthetist and surgeon to establish procedure goals is essential in determining the most appropriate anesthetic management. But does the mode of anesthesia have an impact? Traditionally, inhalational anesthesia was the most common anesthesia technique used during airway surgery. Introduction of agents used for total intravenous anesthesia (TIVA) such as propofol, short-acting opioids, midazolam, and dexmedetomidine has driven change in practice. Ongoing debates abound as to the advantages and disadvantages of volatile-based anesthesia versus TIVA. This pro-con discussion examines both volatiles and TIVA, from the perspective of effectiveness, safety, cost, and environmental impact, in an endeavor to justify which technique is the best specifically for pediatric airway procedures.
小儿气道手术的麻醉是一门真正的艺术，需要经过培训和经验的积累。麻醉师和外科医生之间的沟通对于确定最合适的麻醉管理非常重要，以明确手术目标。但是，麻醉方式会有影响吗？传统上，吸入麻醉是气道手术中最常用的麻醉技术。全凭静脉麻醉（TIVA）中使用的药物的引入，如异丙酚、短效阿片类药物、咪达唑仑和右美托咪定，推动了实践的改变。目前仍存在关于挥发性麻醉剂与 TIVA 各自优缺点的广泛争论。本次正反双方辩论从有效性、安全性、成本和环境影响等方面对挥发性麻醉剂和 TIVA 进行了探讨，旨在确定哪种技术特别适合小儿气道手术。
