Helium insufflation with sevoflurane general anesthesia and spontaneous ventilation during airway surgery.

摘要

PURPOSE: The therapeutic benefits and clinical applications of helium-oxygen gas mixtures were first reported over 70 years ago. Since then, helium has been used in the treatment of obstructive processes of both the upper and lower airways. We report a unique case regarding helium insufflation with sevoflurane anesthesia and spontaneous ventilation for airway surgery. CLINICAL FEATURES: A helium-oxygen mixture was administered during airway surgery in an 8-year-old boy with obstruction of the upper airway. Following the introduction of a helium-oxygen mixture during general anesthesia with spontaneous ventilation, a relatively rapid improvement in the patient's respiratory status was observed with a decrease in the audible inspiratory stridor, improved gas exchange, decreased respiratory rate, decreased suprasternal/intercostal retractions, and a decrease in the transcutaneous CO(2). The physiologic basis for helium's effects on gas exchange are discussed and its use during insufflation for upper airway surgery is reviewed. CONCLUSIONS: The addition of helium improves gas exchange with spontaneous ventilation during general anesthesia for airway surgery.