Adult Laryngotracheal Surgery

Xiao, Peng; Zhang, Xiangwei Shannon

doi:10.1016/j.anclin.2010.07.010

Cited by 8 publications

(4 citation statements)

References 32 publications

(18 reference statements)

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“…Despite these benefits, the use of SV in adult microlaryngoscopy has generally been regarded as less favourable than other open airway techniques such as JV, IV or AO 3,4,8 . It has been associated with patient reactivity, poor operating conditions, and greater difficulty in achieving the required depth of anaesthesia for patients to tolerate microlaryngoscopy while simultaneously maintaining adequate ventilation and haemodynamic stability 1,6,14,15 .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Ventilation Using Target-Controlled Propofol Infusion for Microlaryngoscopy in Adults: A Retrospective Audit

Booth

Vidhani

2016

Anaesth Intensive Care

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We conducted a retrospective audit of 285 adult elective microlaryngoscopy cases in our institution over a three-and-a-half year period. Conventional anaesthesia with intubation and mechanical ventilation was the most common technique, used in 71% of cases. Tubeless spontaneous ventilation during total intravenous anaesthesia with a target-controlled infusion of propofol (SVTCI) was the most common alternative. Spontaneous ventilation with target-controlled infusion was used for 79 (27.7%) anaesthetic inductions and was continued through the maintenance phase for 60 patients (21.1%). Jet and intermittent ventilation were both used infrequently (1% each). The most common SVTCI technique since 2013 involved adjusting the target-controlled infusion rate during induction using a formula we developed based on intermittently increasing the target rate, such that the predicted plasma concentration minus the predicted effect site concentration was maintained at 1 μg/ml. We found that this method maintained ventilation during induction more reliably than other SVTCI strategies, and was associated with fewer complications than other spontaneous ventilation techniques or mechanical ventilation: it was associated with only one (3.1%) failed induction and one (3.9%) episode of apnoea. Jet ventilation was associated with the most severe complications, including two cases of barotrauma.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Ventilation Using Target-Controlled Propofol Infusion for Microlaryngoscopy in Adults: A Retrospective Audit

Booth

Vidhani

2016

Anaesth Intensive Care

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“…La cirugía previa y la radiación pueden causar distorsión anatómica y disfunción al tragar, lo que puede aumentar el riesgo de aspiración y hemorragia. Durante el examen físico básico, se debe palpar el cuello en busca de evidencia de masas, desviación traqueal y plasticidad tisular [18].…”

Section: Incidencia De Dificultad En La Vía Aéreaunclassified

Consideraciones en la valoración de la vía aérea en el paciente con tumor de cabeza y cuello

López¹,

Barrios²,

Guzmán³

et al. 2023

Rev. chil. anest.

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Today, neoplastic disease affecting the patient's head and neck that is amenable to surgical intervention is one of the greatest challenges for anesthesiologists, since few situations present a greater potential risk of airway changes than the patient undergoing surgery for head and neck cancer. Accurate prediction of difficult airway management can reduce potential complications; however, these predictions are of limited value in patients already presenting with head and neck pathology. The (NAP4) Fourth National Audit Project of the Royal College of Anesthetists as well as the (DAS) Difficult Airway Society in the United Kingdom collected reports on major respiratory complications, where in almost 40% of patients, head and neck tumors and their complications related to airway management, and almost 75% of cases where an emergency surgical airway was required, therefore, when considering the airway approach in patients with head and neck tumors, we must know that there is currently a wide variety of devices that offer many possibilities for its management, remembering that the most important thing is not to have each and every one of them, but to establish and develop strategies and management plans, alternative options, in each patient, the possibility of predicting a difficult airway scenario and being able to anticipate events by preparing the equipment and personnel to make the right decisions.

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“…It is not uncommon for these patients to present with anemia. 4 Chronic cigarette smoking and alcohol use can cause induction of the cytochrome P450 multi-enzyme system, leading to increased perioperative requirements for opioids and neuromuscular blockers and generation of higher levels of potentially toxic metabolites of volatile halogenated anesthetic agents. [5][6][7][8] Patients with chronic alcohol consumption require preoperative evaluation of liver function and coagulation status.…”

Section: Literature Reviewmentioning

confidence: 99%

Intraoperative and postoperative complications during microlaryngeal surgery

Marinov

Belitova

Popov

et al. 2021

International Bulletin of Otorhinolaryngology

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Theoretical basis: Patients presenting for microlaryngeal surgery may have a variety of comorbidities contributing to their voice symptoms and affecting anesthetic management. Results: Many patients presenting for laryngeal surgery have a long history of heavy smoking and drinking. Many patients who present for laryngeal surgery are elderly and have cardiovascular disease. The rate of difficult endotracheal intubation may reach almost 16% among patients presenting for ear, nose, or throat cancer surgery, which is on average six times higher than among the general surgical patient population. Loss of the airway on induction, requiring emergent cricothyrotomy or tracheostomy, can be sudden, especially in patients with critical airway obstruction. Prospective trials identify the incidence of dental trauma after suspension laryngoscopy at 0% to 6.5%, depending on the operator's experience, methodology of the study, dental injury criteria, preexisting dentition status of the patient, and suspension technique used. Minor surgical complications, such as sore throat, mucosal injury (e.g., cuts, edema, hematoma), and cranial nerve dysfunction (e.g., lingual, glossopharyngeal, hypoglossal), are most commonly observed. The risk of postoperative airway compromise is significantly greater among the patients who underwent diagnostic laryngoscopy than those in the general surgical population. Conclusion:Patients presenting for microlaryngeal surgery may have a variety of intraoperative and postoperative complications.

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Adult Laryngotracheal Surgery

Cited by 8 publications

References 32 publications

Spontaneous Ventilation Using Target-Controlled Propofol Infusion for Microlaryngoscopy in Adults: A Retrospective Audit

Spontaneous Ventilation Using Target-Controlled Propofol Infusion for Microlaryngoscopy in Adults: A Retrospective Audit

Consideraciones en la valoración de la vía aérea en el paciente con tumor de cabeza y cuello

Intraoperative and postoperative complications during microlaryngeal surgery

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