Question

A 3-day-old, 3-kg neonate with type C tracheoe.sophageal fistula (TEF) presents to the OR for primary repair. After suctioning the upper esophageal pouch and placing the patient in a semi-upright position, which of the following induction techniques is most appropriate?

A. Rapid-sequence intubation with propofol and succinylcholine
B. Inhalation induction with sevofl urane
C. Awake tracheostomy under local anesthesia
D. Awake fi beroptic intubation
E. IV induction with propofol and pancuronium

Answer 1

The most appropriate induction technique for a neonate with type C tracheoesophageal fistula (TEF) is rapid-sequence intubation with propofol and succinylcholine, which ensures a quick and safe way to secure and protect the airway during the repair surgery.

Step-by-step explanation:

The most appropriate induction technique for a 3-day-old, 3-kg neonate with type C tracheoesophageal fistula (TEF) presenting to the OR for primary repair is rapid-sequence intubation with propofol and succinylcholine. This method is chosen due to the risk of aspiration and the necessity of securing the airway quickly since the patient has a connection between the esophagus and trachea which can allow gastric contents to enter the lungs. Rapid-sequence intubation minimizes this risk by providing a fast and secure way to intubate and protect the airway. Endotracheal intubation allows the doctors to maintain an open airway to the lungs and seal the airway off from the oropharynx during anesthesia. Post-surgery, the anesthesiologist can then safely remove the tube when the muscles of respiration begin to function.