# When Neonates Require Anesthesia for the Management of Airway-Related Problems

**Authors:** Beatriz Maio, Marisa Silva

PMC · DOI: 10.7759/cureus.98631 · Cureus · 2025-12-07

## TL;DR

This paper discusses a safe anesthesia approach for neonates with airway issues using a combination of sevoflurane, ketamine, and dexmedetomidine.

## Contribution

The paper introduces a novel anesthetic combination that preserves airway tone and reduces respiratory risks in neonates.

## Key findings

- Anesthesia using sevoflurane, ketamine, and dexmedetomidine preserves airway tone in neonates.
- This combination minimizes the risk of respiratory depression and desaturation during suspension laryngoscopy.
- The approach is ideal for neonates with airway abnormalities undergoing diagnostic or therapeutic procedures.

## Abstract

Suspension laryngoscopy is a valuable tool for the diagnosis and treatment of airway pathologies such as subglottic stenosis in neonates. Propofol and remifentanil sedation are commonly used drugs for this purpose, but there is still concern about their dose-dependent respiratory depression and safety profile in neonates. This clinical case-based discussion presents a premature neonate with respiratory failure and stridor, scheduled for a suspension laryngoscopy. An anesthetic plan using sevoflurane, ketamine, and dexmedetomidine was chosen. This combination preserves airway tone and minimizes the risk of respiratory depression and desaturation, making it an ideal choice for neonates with airway abnormalities.

## Linked entities

- **Chemicals:** sevoflurane (PubChem CID 5206), ketamine (PubChem CID 3821), dexmedetomidine (PubChem CID 5311068), propofol (PubChem CID 4943), remifentanil (PubChem CID 60815)
- **Diseases:** respiratory failure (MONDO:0021113)

## Full-text entities

- **Diseases:** subglottic stenosis (MESH:D007829), airway abnormalities (MESH:D000402), respiratory depression (MESH:D012131), stridor (MESH:D012135)
- **Chemicals:** Propofol (MESH:D015742), dexmedetomidine (MESH:D020927), remifentanil (MESH:D000077208), ketamine (-), sevoflurane (MESH:D000077149)

## Full text

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## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12772071/full.md

## References

8 references — full list in the complete paper: https://tomesphere.com/paper/PMC12772071/full.md

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Source: https://tomesphere.com/paper/PMC12772071