Anesthesia for Laser Surgery of the Airway

Abstract

Anesthesia for laser surgery carries a number of particular challenges and pitfalls. The airway is not only shared with the surgeon but also being operated upon. Personnel working inside the operating room must also be very aware of the benefits and dangers of medical lasers, and safety precautions must be taken to ensure their proper use. The anesthetist must have the knowledge and expertise to anesthetize a patient with a potentially compromised airway. This article deals with the anesthetic management of a patient presenting for laser surgery of the airway.

Use of i-gel for laser ablation of a bronchial lesion

“…Studies with Nd:YAG laser has shown polyvinyl chloride, silicone and red rubber tubes to be vulnerable for damage because of ignition 4–7. Covering of tubes with laser safe material such as copper and aluminium foil is an option, but wrapping is to be done very carefully with a 30% overlap, with no exposed tube, and adhesive used to stick foil is also flammable 7. Commercially available laser-resistant tracheal tubes are expensive and their cuff is inflammable.…”