Anesthetic management for laser excision of recurrent respiratory papillomatosis in a third trimester parturient

Paul A. Tripi, Enas S. Kandil, James E. Arnold

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Recurrent respiratory papillomatosis (RRP) is characterized by the development of laryngeal papillomas, which can produce partial to complete upper airway obstruction. Patients with RRP often require intermittent surgical excision to treat symptoms such as hoarseness and stridor, and to control progression of the lesions. The anesthetic management of such patients is challenging, and it requires carefully coordinated care between an anesthesiologist and otolaryngologist. We present 2 cases of general anesthesia administration during surgical excision of laryngeal papillomas, both occurring during the third trimester of separate pregnancies in the same parturient. The complexity of management was amplified in these cases because of the physiological and anatomical changes associated with pregnancy, along with the need to monitor fetal well-being. Possible complications included complete airway obstruction, pulmonary aspiration of gastric contents, hypoxemia, fetal distress, and preterm labor. Because pregnancy may lead to activation of human papillomavirus, the causative organism of RRP, management guidelines are provided for anesthesiologists who may care for patients with RRP during pregnancy.

Original languageEnglish (US)
Pages (from-to)610-613
Number of pages4
JournalJournal of Clinical Anesthesia
Volume17
Issue number8
DOIs
StatePublished - Dec 1 2005

Keywords

  • Anesthesia
  • Pregnancy
  • Recurrent respiratory papillomatosis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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