Recent developments in airway management of the paediatric patient.
OBJECTIVE
During the last two years, several studies have enhanced our knowledge about the influence of pharmacological agents and routine airway management manoeuvres on the airway of paediatric patients. New supraglottic airway devices have been introduced into routine paediatric anaesthesia practice, and the design of paediatric endotracheal tubes has been modified. This review summarizes the most recent and relevant scientific developments in paediatric airway management.


RESULTS
Strong evidence has been gained that the lateral position is the best to ensure a clear airway in anaesthetized or sedated spontaneously breathing children. Remifentanil has emerged as an appealing drug for airway management in anaesthetized or sedated children. The paediatric ProSeal-Laryngeal mask airway offers important advantages over the Classic-Laryngeal mask airway for supraglottic airway management. The newly designed Microcuff paediatric endotracheal tube offers an improved age-appropriate design.


CONCLUSIONS
Remifentanil has found a place in airway management in paediatric patients. Recent improvements in the design of paediatric supraglottic airway devices and endotracheal tubes are promising. Further research is needed to consolidate their role in improving the perioperative outcome in paediatric patients.
Goldmann
Kai
K
Airway Management Research and Training Centre, Department of Anaesthesia and Intensive Care Therapy, University Clinic Giessen-Marburg, Campus Marburg, Philipps University Marburg, Marburg, Germany. Kaigoldmann1@aol.com
D000701:Analgesics, Opioid / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000379:methods*; D017214:Laryngeal Masks; D010880:Piperidines / Q000008:administration & dosage; D011187:Posture / Q000502:physiology; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil