Esophageal balloon dilation in children: prospective analysis of hemodynamic changes and complications during general anesthesia.
OBJECTIVE
To investigate hemodynamic changes and complications in children during balloon dilation of esophageal strictures.


METHODS
Prospective, controlled study.


METHODS
University teaching hospital.


METHODS
5 ASA physical status I and II pediatric patients with benign esophageal stricture related to ingestion of caustic substances.


METHODS
Anesthesia was induced with intravenous propofol two mg/kg and cisatracurium 0.2 mg/kg and maintained with 66% nitrous oxide and one minimum alveolar concentration of sevoflurane in oxygen. In each session, balloon size was increased until the stricture was opened.


RESULTS
A total of 18 sessions and 99 dilations in 5 children performed over a one-year period were included in the study. In 8 of 18 sessions, esophageal stricture was located in the middle one third of the esophagus; and in the others, in the upper one third. Four cases experienced bleeding; two cases, inability to ventilate due to obstruction of the endotracheal tube tip by the inflated balloon; and two cases, postextubation bronchospasm. In 95 of the 99 dilations, while the balloon was inflated, heart rate was faster and blood pressure increased significantly.


CONCLUSIONS
Anesthesiologists should keep in mind the possibility of hemodynamic instability and possible endotracheal tube tip obstruction by the inflated balloon and safeguard the airway against bleeding, secretions, and radio-opaque fluid during esophageal balloon dilation.
Gerçek
Arzu
A
Department of Anesthesiology and Reanimation, Institute of Neurological Science, Marmara University, 34854 Istanbul, Turkey. arzugercek@yahoo.com
Ay
Binnaz
B
Dogan
Varlik
V
Kiyan
Gursu
G
Dagli
Tolga
T
Gogus
Yilmaz
Y
D000768:Anesthesia, General; D001794:Blood Pressure; D001831:Body Temperature; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D004940:Esophageal Stenosis / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal; D011446:Prospective Studies