Postoperative medical management in single-stage laryngotracheoplasty.
OBJECTIVE
To determine whether it is safe and effective to avoid the use of neuromuscular relaxants in patients who have indwelling nasotracheal tubes after undergoing single-stage laryngotracheoplasty.


METHODS
Retrospective case series.


METHODS
University-based referral center specializing in the surgical management of laryngotracheal stenosis and other pathologic conditions of the airway.


METHODS
Referred sample of 104 consecutive patients (67 males, 37 females) undergoing single-stage laryngotracheoplasty for subglottic stenosis.


METHODS
Single-stage laryngotracheoplasty.


METHODS
Incidence of accidental extubation, use of neuromuscular relaxants, incidence of reintubation after planned extubation, duration of intubation, overall rate of successful airway expansion.


RESULTS
One patient self-extubated without sequelae. One patient required a brief course of neuromuscular relaxants. The success rate (without further laryngotracheoplasty) for all patients was 86% (89/104). For the 25 patients operated on in 1992, with at least 1 year of follow-up, the success rate was 92% (23/25).


CONCLUSIONS
Single-stage laryngotracheoplasty can be done safely and effectively without using paralyzing agents in the postoperative period. This approach has certain advantages, which are discussed.
Rothschild
M A
MA
Department of Pediatric Otolaryngology, Children's Hospital Medical Center, University of Cincinnati School of Medicine, Ohio, USA.
Cotcamp
D
D
Cotton
R T
RT
D000059:Accidents; D000293:Adolescent; D000402:Airway Obstruction / Q000601:surgery; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D002356:Cartilage / Q000637:transplantation; D002648:Child; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007442:Intubation, Intratracheal / Q000295:instrumentation; D007829:Laryngostenosis / Q000601:surgery*; D007830:Larynx / Q000601:surgery*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage; D011182:Postoperative Care; D012189:Retrospective Studies; D013997:Time Factors; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*; D014140:Tracheotomy; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents; D002697:Chloral Hydrate; D008874:Midazolam