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

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.