Interdisciplinary cooperation in CO2 laser microsurgery of larynx in general anaesthesia with jet ventilation

Article Sidebar

PDF (Język Polski)


Published: Jun 30, 2018
DOI: https://doi.org/10.24292/01.AP.214250618
Keywords:
microsurgery of larynx, laser microsurgery jet ventilation, directoscopy

Main Article Content

Wiesława Liberowicz
Oddział Anestezjologii i Intensywnej Terapii, Wielkopolskie Centrum Onkologii w Poznaniu
Stefan Stamm
Oddział Anestezjologii i Intensywnej Terapii, Wielkopolskie Centrum Onkologii w Poznaniu
Piotr Pieńkowski
Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu; Wielkopolskie Centrum Onkologii im. Marii Skłodowskiej-Curie
Wojciech Golusiński
Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu; Wielkopolskie Centrum Onkologii im. Marii Skłodowskiej-Curie

Abstract

Background: Microsurgery of larynx requires free access to the operation field. It is possible under general anaesthesia with high frequency jet ventilation. Shared upper airway demands anaesthesiologist and surgeon cooperation.


Methods: 40 patients scheduled for laser CO2 microsurgery were included in the study. 20 of patients presented malignant pathology and 20 benign lesions. Anaesthetic risk was assessed in ASA-scale. Patients under 18 and above 80 years old, with severe COPD and renal or hepatic failure were excluded. This article deals with preoperative assessment and management of general anaesthesia. Conditions for intubation were assessed using Krieg-score and conditions for surgery were assessed by surgeon using Likert-scale.


Results: Presented method of anaesthesia enables efficient and safe surgical treatment. Conditions for surgery were highly scored by surgeon.


Discussion: High risk of complications is associated with microsurgery of larynx under general anaesthesia with jet ventilation. Close cooperation between surgical and anaesthetic teams is essential for safety of this procedure.

Downloads

Download data is not yet available.

Article Details

How to Cite
Liberowicz , W., Stamm , S., Pieńkowski , P., & Golusiński , W. (2018). Interdisciplinary cooperation in CO2 laser microsurgery of larynx in general anaesthesia with jet ventilation. Alergoprofil, 14(2), 35-40. https://doi.org/10.24292/01.AP.214250618
Issue
Vol 14 No 2 (2018)
Section
Article

Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

References

1. Charlton G.A., Wainwright A.C.: Anaesthesia for Laser Surgery of the Upper Airway. Curr. Anaesth. Crit. Care 1994, 5: 81-87.
2. Shah S.M., Kapadi M.S., Shah D.R. et al.: Anaesthesia For Laser Surgery Of Larynx. Gujarat Med. J. 2014, 69(1): 17-20.
3. Babinski M., Smith R.B., Klain M.: High-frequency jet ventilation for laryngoscopy. Anesthesiology 1980, 52: 178-180.
4. Evans E., Biro P., Bedforth N.: Continuing Jet ventilation. Education in Anaesthesia. Crit. Care Pain 2007, 7(1): 2-5.
5. Jaquet Y., Monnier P., Van Melle G. et al.: Complications of Different Ventilation Strategies in Endoscopic Laryngeal Surgery A 10-year Review. Anesthesiology 2006, 104: 52-59.
6. MacMillan M.H., Davidson M.: Anaesthesia for endoscopic surgery. Anaesth. Intens. Care Med. 2017, 18(4): 196-198.
7. Krieg N., Mazur L., Booij L.H., Crul J.: Intubation conditions and reversibility of a new non-depolarizing blocking agent, NC-45. Acta Anaesthesiol. Scand. 1980, 24: 423-425.
8. Tang F., Li S.Q., Chen L.H., Miao C.H.: The comparison of various ventilation modes and the association of risk factors with CO2 retention during suspension laryngoscopy. Laryngoscope 2011, 121(3): 503-508.
9. Murphy G.S.: Neuromuscular Monitoring in the Perioperative Period. Anesth. Analg. 2018, 126(2): 464-468.
10. Paech M.J., Kaye R., Baber C., Nathan E.A.: Recovery characteristics of patients receiving either sugammadex or neostigmine and glycopyrrolate for reversal of neuromuscular block: a randomised controlled trial. Anaesthesia 2018, 73: 340-347.
11. Huh H., Park S.J., Lim H.H. et al.: Optimal anesthetic regimen for ambulatory laser microlaryngeal surgery. Laryngoscope 2017, 127(5): 1135-1139.
12. Choi E.S., Oh A.Y., Koo B.W. et al.: Comparison of reversal with neostigmine of low-dose rocuronium vs. reversal with sugammadex of high-dose rocuronium for a short procedure. Anaesthesia 2017, 72: 1185-1190.
13. Wang H., Yang C., Zhang B. et al.: Efficacy of target-controlled infusion of propofol and remifentanil with high frequency jet ventilation in fibre-optic bronchoscopy. Singapore Med. J. 2013, 54(12): 689-694.
14. English J., Norris A., Bedforth N.: Anaesthesia for airway surgery. Continuing Education in Anaesthesia, Critical Care & Pain 2006, 6(1): 28-31.
15. Kitching A.J., Edge C.J.: Lasers and surgery. Br. J. Anaesth. 2003, 8(5): 143-146.
16. Cook T.M., Alexander R.: Major complications during anaesthesia for elective laryngeal surgery in the UK: a national survey of the use of high-pressure source ventilation. Br. J. Anaesth. 2008, 101(2): 266-272.
17. Mikkelsen S., Knudsen K.E.: Pneumopericardium associated with high-frequency jet ventilation during laser surgery of the hypopharynx in a child. Eur. J. Anaesthesiol. 1997, 14(6): 659-661.
18. Gilbert T.: Gastric rupture after inadvertent esophageal intubation with jet ventilation catheter. Anestesiology 1998, 88: 537-538.