A Clinical Study of Anesthesia for Tracheoesophageal Fistula with Esophageal Atresia / 대한마취과학회지

ABSTRACT

Two cases of anesthetic experience with tracheoesophageal fietula with esophageal atresia have-been reported and the literature reviewed. On the fifth day of life, anesthesia was induced and maintained with nitrous oxide-oxygen- halothane using Ohio infant circle absorber, preceded by awake endotracheal intubation with the aid of intramuscular injection of succinylcholine chloride following preliminary oxygenation. Gastro-stomy was performed prior to surgery. Tracheoesophageal fistula was divided and the esophagus anastomosed. In the first case surgical manipulation of the lungs and trachea caused complete airway obstruction and momentary cardiac arrest, which was successfully treated with I.V. calcium gluconate and sodium bicarbonate. Both infants made otherwise uneventful recoveries. The importance of preliminary gastrostomy, atraumatic intubation, maintenance of adequate ventilation and circulation, frequent suctioning of airway secretions, and of treating pulmonary complications have been stressed.