Abstract
Background and Aims: Smooth and safe general anaesthesia in compromised airway with abnormal anatomy, sharing of airway with surgeon, avoidance of potential laser hazards, prevention of awareness, wide awake patient after surgery with least postoperative complication are main challenges for anaesthesia for laryngeal laser surgery.
Methodology: The study was conducted on thirty patients of American Society of Anesthesiologists Grade I and II of age group 18–58 years, posted for elective laryngeal laser surgeries to study the outcome of our anaesthetic management. We also emphasized on currently available measures to prevent problems of laser surgery.
Results: None of the patents in our study shows complications except four patents represent difficulty in breathing postoperatively due laryngeal edema and managed accordingly.
Conclusion: With use of safety measures and special techniques for anaesthesia, the problems of laryngeal laser surgery are minimized.
Keywords: laser in ENT surgery, Safe anaesthesia techniques, operating room hazards.
References
- Dhar, A. Malik / Anesthesia for laser surgery in ENT and the various ventilatory techniques Trends in Anaesthesia and Critical Care 1 (2011) 60e66 .
- Tomit Y, Mihashi S, Nagata Kea. Mutagenicity of smoke condensates induced by CO2 laser and electrocauterisation. Mutat Res 1981;89:145.
- Kokosa J, Eugene J. Chemical composition of laseretissue interaction smoke plume. J LaserAppl 1989;2:59e63.
- Smith J, Moss C, Byrant CJ, Fleeger AK. Evaluation of a smoke evacuator used for laser surgery. Lasers Surg Med 1989;9:276.
- Meyers A. Complications of CO2 laser surgery of the larynx. Ann Otol, 1981; 90: 132-4.
- Tomit Y, Mihashi S, Nagata Kea. Mutagenicity of smoke condensates induced by CO2 laser and electrocauterisation. Mutat Res 1981;89:145.
- Kokosa J, Eugene J. Chemical composition of laseretissue interaction smoke plume. J LaserAppl 1989;2:59e63.
- Smith J, Moss C, Byrant CJ, Fleeger AK. Evaluation of a smoke evacuator used for laser surgery. Lasers Surg Med 1989;9:276.
- Smith J, Topmiller J, Shulman S. Factors affecting emission collection by surgical smoke evacuators. Lasers Surg Med 1990;10:224.
- Faintuch J. Endoscopic laser therapy in colorectal carcinoma. Hematol Oncol Clin North Am 1989;3:155.
- Dittrich K, Armbruster C, Hoffer F. Nd:YAG laser treatment of colorectal malignancies: an experience of 4 1/2 years. Lasers Surg Med 1992;12:199.
- Peache T, Eason J, Moxham J. Systemic air embolism during laser bronchoscopy. Anesthesia 1988;43:872.
- Ross DJ, Mohsenifar Z, Potkin RT, Roston WL, Shapiro SM, Alexander JM. Pathogenesis of cerebral air embolism during Nd-YAG laser photoresection. Chest 1988;94:660.
- Laser drapes fire. How much of a risk? Lasers Med Surg 1989;7:2. 11.
- American National Standard for safe use of lasers; 1996. p. Z136.1.
- Baer G, Paloheimo M, Rahnasto J, et al. End-tidal oxygen concentration and pulse oximetry for monitoring oxygenation during intratracheal ventilation. J Clin Monit 1995; 11: 37
- Cowl CT, Prakash UB, Kruger BR. The role of anticholinergics in bronchoscopy: a randomised, clinical trial. Chest 2000; 118: 188
- McRae K. Anesthesia for airway surgery. Anesthesiol Clin North America 2001; 19: 497–541,
- Kain ZN, O’Connor EZ, Berde CB. Management of tracheobronchoscopy and esophagoscopy for foreign bodies in children: A survey study. J Clin Anesth1994; 6: 28.
- Rampil IJ. Anesthesia for laser surgery. In: Miller RD, ed. Miller's anesthesia, 6th ed. Philadelphia: Churchill Livingstone, 2005:2573-2588.
- Anesthesia for airway surgery. Anesthesiol Clin North America 2001;19(3):497-541.
- Werkhaven JA. Microlaryngoscopy-airway management with anaesthetic techniques for CO2 laser. Pediatr Anesth 2004;14:90- 94.
- Jaquet Y, Monnier P, Van Melle G, et al. Complications of different venti lation strategies in endoscopic laryngeal surgery. A 10 year review.Anesthesiology 2006;104:52-59.
- Borland LM. Airway management for CO2 laser surgery on the larynx: venturi jet ventilation and alternatives. Int Anesthesiol Clin 1997;35:99-106.
Corresponding Author
Dr Muqtasid Rashid
Sr. Resident, Department of Anesthesiology & Critical Care
Govt. Medical College, Srinagar, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile No: +91-9797798382
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.40
