The Use of Dexamethasone-21-Phosphate for the Reduction of Laryngeal Edema in Intubation Anesthesia.

Abstract

As the field of anesthesia for general dentistry develops, the dentist anesthesiologist is confronted with new problems. One of the problems to which the dentist addresses himself is the maintenance of the airway. Although the techniques for maintaining the airway with the use of a nosepiece or nasopharyngeal airway are being constantly perfected, the technique of nasotracheal intubation can be used with great success on all patients and must be used on some patients. It is in the use of nasotracheal intubation where postoperative respiratory problems are likely to arise. The most common problem, and least troublesome, is the sore throat. This is a universal problem regardless of the trauma of intubation. The reaction of the patient after a smooth intubation will depend on the length of the procedure, size and flexibility of the tube, age of the patient, and subjective reaction of the patient. It is in children, particularly from age five and younger, where the more serious postoperative nasotracheal intubation sequelae occur. These sequelae may involve mild laryngitis and tracheitis, severe laryngitis and tracheitis and even laryngeal edema. The symptoms may be wheezing, coughing and difficulty in breathing. The most severe problem takes the form of a severe croup with great difficulty in breathing.