• M A Rothschild, D Cotcamp, and R T Cotton.
• Department of Pediatric Otolaryngology, Children's Hospital Medical Center, University of Cincinnati School of Medicine, Ohio, USA.
• Arch Otolaryngol. 1995 Oct 1; 121 (10): 1175-9.

ObjectiveTo determine whether it is safe and effective to avoid the use of neuromuscular relaxants in patients who have indwelling nasotracheal tubes after undergoing single-stage laryngotracheoplasty.DesignRetrospective case series.SettingUniversity-based referral center specializing in the surgical management of laryngotracheal stenosis and other pathologic conditions of the airway.PatientsReferred sample of 104 consecutive patients (67 males, 37 females) undergoing single-stage laryngotracheoplasty for subglottic stenosis.InterventionSingle-stage laryngotracheoplasty.Main Outcome MeasuresIncidence of accidental extubation, use of neuromuscular relaxants, incidence of reintubation after planned extubation, duration of intubation, overall rate of successful airway expansion.ResultsOne patient self-extubated without sequelae. One patient required a brief course of neuromuscular relaxants. The success rate (without further laryngotracheoplasty) for all patients was 86% (89/104). For the 25 patients operated on in 1992, with at least 1 year of follow-up, the success rate was 92% (23/25).ConclusionSingle-stage laryngotracheoplasty can be done safely and effectively without using paralyzing agents in the postoperative period. This approach has certain advantages, which are discussed.

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