Avoiding a wrapped endotracheal tube in laser laryngeal surgery: Experiences with apneic anesthesia and metal laser‐flex endotracheal tubes

Abstract

Ninety-one laser laryngeal procedures using the apneic technique of anesthesia were performed in 28 patients between 2 months and 64 years of age. Seventy-two procedures (79%) were performed on children and 19 on adults. There were no complications. Eight laser laryngoscopies were performed using a new metal Laser-Flex endotracheal tube. Obstruction of the endotracheal tube with a mucous plug occurred in one case. The apneic technique described in this paper provides a laser operative field free of an endotracheal tube, virtually eliminating the danger of a laser fire. It is a relatively safe and effective means of performing laser laryngeal surgery. In addition, the Laser-Flex endotracheal tube appears to be an acceptable alternative to a metallic tape-wrapped endotracheal tube.

Strategies for CO2 Laser Use in Laryngeal Microsurgery: A Systematic Review

“…A total of 14 studies outlined general safety measures and perioperative strategies for TOLMS not specific to particular conditions including for instance: neoplasms, nodules, polyps, stenoses, BVCP, laryngoceles, hemangiomas, and papilloma (Supplemental Table S9, available online). [98][99][100][101][102][103][104][105][106][107][108][109][110][111] These studies were conducted in 7 different countries, with the United States (n = 8) being the most commonly represented.…”

“…[98][99][100][102][103][104][106][107][108][109][110] One study additionally reported using either apnea or ETI. 101 The importance of multiple preoperative measures was described including, for instance, warning signs on operating room doors (n = 2), the availability of fire extinguishing kits (n = 2), and the use of laser-safe or laser-protected ETT (n = 8). [98][99][100][101][102] Intraoperatively, authors described the use of wet gauze in the subglottis and systemic or topical corticosteroids.…”

“…101 The importance of multiple preoperative measures was described including, for instance, warning signs on operating room doors (n = 2), the availability of fire extinguishing kits (n = 2), and the use of laser-safe or laser-protected ETT (n = 8). [98][99][100][101][102] Intraoperatively, authors described the use of wet gauze in the subglottis and systemic or topical corticosteroids. 98,99,101,102,105,108,111 Postoperatively, many authors reported nursing patients with humidified oxygen.…”

“…[98][99][100][101][102] Intraoperatively, authors described the use of wet gauze in the subglottis and systemic or topical corticosteroids. 98,99,101,102,105,108,111 Postoperatively, many authors reported nursing patients with humidified oxygen. 100,101,110…”

“…98,99,101,102,105,108,111 Postoperatively, many authors reported nursing patients with humidified oxygen. 100,101,110…”