Clinical Consideration of Anesthetic Management for Otolaryngeal Laser Surgery

Lee, Hee Kyung; Lee, Sang Mok; Kwon, Byung Yon

Abstract

The laser provides the surgeons with several advantages and are capable of providing very high intensity output that can be collimated, resulting in spots sized on the order of the wave length of light, having extremely high energy density, therefore pathological tissues can be removed without blood loss or surrounding tissue edema. There are some problems related to anesthetic management for otolaryngeal laser sugery. One such problem is flamibility of endotracheal tube by the laser light and the difficulties of keeping airway open during the surgery. The anesthesiologist should understasnd the character and the hasards of laser light for both the patients and the others in the operating room. We have clinically analyzed 282 cases of otolaryngeal laser surgery to study their hasards and the anesthetic problems, from January 4th 1988 to December 31,1990. in Wallace Memorial Hospital, Pusan, Korea. The results were as follows 1) Endotracheal tube cuff perforation has occured during otolaryngeal laser sugery in 10.6 percent by the biginner surgeons, and 1.8 percent by expert surgeons. 2) Endotracheal tube firing did not occured by using the endotracheal tube, that was wrapped with aluminum foil tape. 3) Kinking of the endotracheal tube occured frequently by using these tubes during otolaryngeal laser surgery in 5.7 percent by biginner surgeons and 1.4 percent by expert surgeons.