Spontaneous respiration anesthesia for respiratory papillomatosis

Several anesthetic techniques for microlaryngeal laser surgery in children have been advocated. The objective of this study was to evaluate the operat ive conditions and safety of the spontaneous respiration anesthesia techniq ue for carbon dioxide laser surgery in children with recurrent respiratory papillomatosis (RRP). The anesthetic and operative records of 60 pediatric patients with RRP who underwent microlaryngeal laser surgeries between 1991 and 1997 were reviewed. Papilloma location, severity of involvement, oxyge n saturation, airway stability, need for intubation, duration of procedure, and complications were recorded. The patients underwent 744 surgical proce dures. Two hundred two procedures were randomly studied (statistical power greater than or equal to 80%). The supraglottis and glottis were most commo nly involved. Most of the papillomas were graded as moderate or severe dise ase. Complications occurred in 11 procedures. The surgical procedure was co mpleted in all cases. No variable had predictive value regarding the outcom e. Spontaneous respiration anesthesia is an efficient and relatively safe t echnique for microlaryngeal laser surgery in children with RRP.