| Vocal cord function and bispectral index in pediatric bronchoscopy patients emerging from propofol anesthesia. | |
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MedLine Citation:
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PMID: 20425858 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: In children undergoing bronchoscopy for evaluation of stridor or respiratory symptoms, movement of the vocal cords is routinely assessed at the conclusion of flexible bronchoscopy with children still anesthetized. The effect of anesthesia on vocal cord function is not well described. This study aimed to characterize the relationship between depth of propofol anesthesia, as measured by Bispectral Index (BIS), and vocal cord movement in pediatric patients. METHODS: Children between 6 months and 12 years of age presenting for diagnostic flexible bronchoscopy were enrolled in this prospective observational study. Anesthesia was maintained with a propofol infusion which was discontinued upon completion of the lower airway evaluation. An independent observer recorded the BIS score every 15 sec from discontinuation of propofol whereas the pulmonologist continued to observe vocal cord motion. BIS scores were also recorded for each observed clinical endpoint (paradoxical and normal vocal cord movement, complete vocal cord closure, and volitional movement). RESULTS: Data were analyzed for 47 subjects. The BIS values increased significantly from the conclusion of the lower airway evaluation with return of normal vocal cord movement, complete vocal cord closure, and volitional movement (P < 0.0005). BIS readings were higher for patients younger than 2 years. Paradoxical vocal cord movement was documented in 10.6% of subjects, but resolved in all subjects. CONCLUSIONS: Our findings suggest that return of vocal cord function during emergence from propofol anesthesia is related to decreasing anesthetic depth with complete vocal cord closure occurring at BIS values near those associated with volitional movement. |
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Authors:
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Hedwig Schroeck; Karamarie Fecho; Kathleen Abode; Ann Bailey |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric pulmonology Volume: 45 ISSN: 1099-0496 ISO Abbreviation: Pediatr. Pulmonol. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-28 Completed Date: 2010-07-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8510590 Medline TA: Pediatr Pulmonol Country: United States |
Other Details:
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Languages: eng Pagination: 494-9 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7010, USA. hschroeck@aims.unc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia Recovery Period Anesthetics, General / administration & dosage, adverse effects* Bronchoscopy / adverse effects* Child Child, Preschool Humans Infant Propofol / administration & dosage, adverse effects* Prospective Studies Respiratory Sounds / diagnosis*, drug effects, physiopathology Vocal Cords / drug effects*, physiopathology* |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, General; 2078-54-8/Propofol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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