ANESTHESIOLOGICAL TECHNIQUE IN LARYNGEAL LASER-SURGERY

Laser surgery can be performed using either endotracheal intubation, apnoea or jet ventilation. For operations performed under endotracheal intubation the same technical rules apply as for any other type of anaesthesia. To facilitate intubation a special laser tube is required. The Mallinckrodt Laser-Flex Tracheal Tube has the best physical qualities of all endotracheal catheters available commercially. Aspiration prophylaxis using ranitidine and metoclopramide is recommended for procedures under apnoea or using jet ventilation. For monitoring purposes during jet ventilation or procedures under apnoea, transcutaneous oximetry, ECG recording as well as non-invasive blood pressure measurements at short intervals is mandatory. In addition video monitoring is desirable to allow visual anaesthesiological surveillance of the larynx. The jet ventilator must meet established standards; the option must be available to survey inspiratory peak pressure and end-expiratory pressure as well as the setting of appropriate alarm limits.