Voice professionals and associated anaesthetic risk: a proposal to a perioperative airway-protective care bundle

Abstract

Background: Voice professionals subjected to surgical procedures or anaesthesia are particularly susceptible, considering the multi-factor potential for damaging the vocal system. Such injuries are the most common reasons for anaesthetic morbidity and have even more serious repercussions for singers. Surgery in the abdominal region is singularly important, considering the vital role that abdominal support plays for respiratory dynamics and vocalisation. Perioperative management and planning and strict anaesthetic practices are fundamental for minimising this risk and promoting an optimum clinical outcome. The lack of guidelines adapted to this context justifies the need to gather together and review all existing evidence, which this case study aims to do. Case presentation: The clinical case concerns a 46year old female, a light opera singer, admitted for laparoscopic cholecystectomy. It describes the ample pre-anaesthetic assessment and education and lists the protective technical and pharmacological choices adopted during the surgery. The subsequent follow-up serves as the starting point for reflecting on the results obtained, preparing a suggested sequential approach for each perioperative stage. Conclusion: Even though vocal damage depends on the surgical and anaesthetic approach during the operation, anaesthesia for voice professionals requires rigorous planning beforehand, often being more complex than the surgical procedure. A multifaceted intervention including counselling, less invasive anaesthetic practices and systematic follow-up promote the key strategy – overall protection.