Evaluation of Endotracheal Tube Safety for CO<sub>2</sub> Laser Resurfacing

Ferguson, John C.; Carr, Rebecca T.; Chang, Edward W.; Farrior, Edward H.

doi:10.1097/00005537-200207000-00018

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…Since its development in the 1960s lasers have become a popular tool in surgery [1]. This is due to a number of reasons including their accuracy and haemostatic properties.…”

Section: Introductionmentioning

confidence: 99%

Laser safety in head and neck cancer surgery

Ahmed

Kinshuck

Harrison

et al. 2010

Eur Arch Otorhinolaryngol

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The use of trans-oral laser techniques for the resection of head and neck carcinomas has increased exponentially over the last four decades. Inadvertent laser damage to the patient or operating theatre staff is an acknowledged risk. However, no data exist to verify the safety margin of commonly employed precautions. The aims of this study was to assess the safety margins of protective strategies commonly adopted when using CO(2) lasers to resect tumours of the head and neck. A Sigmacon Acupulse Lumenis CO(2) laser was evaluated. The beam was focused to 2 mm diameter at 402 mm focal length. Gauze swabs, neurosurgical patties, surgical gloves, paper drapes and conventional endotracheal (ET) tubes were tested against the following laser variables: power, beam characteristics and angle of beam incidence (90 & 45°). Laser penetration time through the material under test was recorded in seconds (s). All the materials where tested dry and some, when appropriate, were tested wet. The mean of three recordings was calculated. The results demonstrated dry gauze swabs, neurosurgical patties and paper drapes provided 0 s protection at 2 W (lowest power). However, when wet, the laser failed to penetrate the swabs and neurosurgical patties, even after 180 s of continuous application. Gloves (single or double layer), and ET cuffs were penetrated in less than 1 s at 2 W. Time to penetrate a size 6.0 ET tube at 2 W continuous setting increased from <1 s at 90° to 42 s at 45°. These data are essential for anyone using CO(2) lasers for the resection of head and neck tumours. The importance of keeping laser consumables wet throughout the procedure is highlighted. The angle at which the laser hits the ET tube may impart some protection against airway fire but the data support the need to cover the ET tube with damp swabs or neuropatties when possible.

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“…Since its development in the 1960s lasers have become a popular tool in surgery [1]. This is due to a number of reasons including their accuracy and haemostatic properties.…”

Section: Introductionmentioning

confidence: 99%

Laser safety in head and neck cancer surgery

Ahmed

Kinshuck

Harrison

et al. 2010

Eur Arch Otorhinolaryngol

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“…[8][9][10][11][12][13][14] In addition, controlled studies have been performed to test the safety of lasers on ETTs in head and neck surgery. 7,[15][16][17][18][19][20][21][22] Since the advent of the carbon dioxide laser, many alternative lasers have been developed, each intended for a specific target. 23 The KTP laser was developed in the 1980s from the Nd:YAG laser and preferentially targets oxyhemoglobin.…”

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confidence: 99%

“…23 Multiple studies have been performed to evaluate the effect of patties as a safety buffer to protect the airway and ETT during carbon dioxide laser surgery, but the interaction of patties and ETTs with the KTP laser has not been assessed. 7,15,29 To our knowledge, there has been no investigation of the interaction of the KTP laser with commonly used transoral laser surgery supplies. In this study, we evaluated the safety of the KTP laser in transoral laser surgery by testing the time to perforation of various ETTs after exposure to a KTP laser.…”

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confidence: 99%

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Evaluating the Effects of a 532‐nm Fiber‐Based KTP Laser on Transoral Laser Surgery Supplies

Coughlan

Verma

2013

Otolaryngol.--head neck surg.

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“…Heat‐resistant constructions of endotracheal tubes may cause complications during laser surgery. To avoid these accidents, vigilance is required from both surgeons and anesthesiologists 2–5 …”

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confidence: 99%