Continuous Intravenous Anesthesia with Etomidate for Carbon Dioxide Laser Surgery of the Larynx

A method for studying the pharmacodynamic profile of neuromuscular blocking agents on vocal cord movements in anaesthetized cats

“…In contrast, the skeletal adductor pollicis muscle was nearly completely (97-100%) blocked. These findings support clinical observations (Sia et al, 1982). Movement of the vocal cords involves a complex combination of action of the intrinsic laryngeal muscles, controlled by, in part, the superior but predominantly, by the inferior laryngeal nerves.…”

“…In addition, it has been reported that the magnitude and time-course of action of muscle relaxants differ significantly between the intrinsic laryngeal muscles and peripheral skeletal muscles (Gabriel, 1975;Baer, 1984). This may explain intubation difficulties and complications encountered during upper airway surgery (Baer & Pukander, 1982;Sia et al, 1982). One of the objectives in the development of new neuromuscular blocking agents is that the 'ideal' relaxant should have a fast onset to facilitate rapid intubation .…”

Midazolam-Flumazenil Topical Anaesthesia for Microlaryngoscopy with Jet Ventilation

“…Microlaryngoscopic procedures under general anaesthesia and jet ventilation require a deep level of anaesthesia with a smooth induction, prompt awakening, and rapid recovery of cough reflex to prevent possible aspiration of blood and debris 2,6,12 . It is difficult to cope with the variation in surgical stimuli and the individual patient's response which alter anaesthetic needs, even with various complex dose regimens and infusion schemes of short-acting intravenous anaesthetics (propofol, thiopentone, methohexitone, etomidate and althesin) [1][2][3][4][5][6][7] . These dose regimens were designed to keep blood concentration at the desired level and need further clinical adjustment during the procedures.…”

“…Total intravenous anaesthesia (TIVA) in combination with venturi jet ventilation has been used for microlaryngeal surgery involving vocal cord and other procedures in the upper airway for many years [1][2][3][4][5] . Continuous infusion or intermittent injection of various ultra-short-acting intravenous anaesthetics (e.g.…”

“…Continuous infusion or intermittent injection of various ultra-short-acting intravenous anaesthetics (e.g. thiopentone, methohexitone, etomidate, althesin and propofol) have been successfully used for years [1][2][3][4][5][6][7] . A number of complex dose regimens and infusion schemes have been devised in order to keep the blood concentration at the desired level, but it is still difficult to provide adequate anaesthesia to cope with individual variation in responses to surgical stimuli.…”