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European Archives of Oto-Rhino-Laryngology

, Volume 248, Issue 8, pp 475–478 | Cite as

Tubeless translaryngeal superimposed jet ventilation

  • A. Aloy
  • M. Schachner
  • W. Caucura
Original Investigations

Summary

Microsurgical endoscopic interventions of the larynx offer an optimal approach to the surgeon by providing an unrestricted operative field. During such operations, ventilating the patient should in no way be impaired. For this reason we have developed a new type of tubeless jet ventilation which consists of both low-frequency and superimposed high-frequency jet ventilation. In addition, we have integrated two specifically sized jets into a Kleinsasser laryngoscope, placing them at different sites. This technique guarantees adequate ventilation with an oxygen-air blend. Due to the Venturi effect, air and tidal volumes are also enhanced when passing through the external open end of the laryngoscope. This type of tubeless jet ventilation was applied to more than 60 patients, using a prototype jet. Anesthesia consisted of a continuous intravenous administration of propofol, with sufentanil and vecuronium given as needed. Clinical results revealed optimal ventilation of all patients without hypercapnia or other complications. Operative conditions for the surgeon were also very satisfactory. Findings demonstrated that this type of tubeless jet ventilation is also particularly suited for laryngeal laser surgery, thus avoiding flammable tubes and noxious anesthetics.

Key words

Microlaryngeal surgery Anesthesia High-frequency tubeless jet ventilation Venturi effect 

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References

  1. 1.
    Aloy A, Schachner M, Spiss CK, Cancura W (1990) Tubuslose translaryngeale superponierte Jet-Ventilation. Anaesthesist 39:493–498Google Scholar
  2. 2.
    Babinski M, Smith RB, Klain M (1980) High-frequency jet ventilation for laryngoscopy. Anaesthesiology 52:178–180Google Scholar
  3. 3.
    Baer GA, Pukander J (1982) Arbeitsbedingungen und Komplikationen bei Laryngomikroskopien, intratracheal ventiliert durch Intubationstuben oder mit Injektor-Ventilation. Anaesthesist 31:621–624Google Scholar
  4. 4.
    Borg U, Eriksson I, Sjöstrand U (1980) High-frequency positive-pressure ventilation (HFPPV): a review based upon its use during bronchoscopy and for laryngoscopy and microsurgical surgery under general anesthesia. Anesth Analg 59:594–603Google Scholar
  5. 5.
    Carden E, Ferguson GB (1973) A new technique for microlaryngeal surgery in infants (abstract). Laryngoscope 83:691–699Google Scholar
  6. 6.
    Carden E, Vest HR (1974) Further advances in anesthetic technics for microlaryngeal surgery. Anesth Analg 53:584–587Google Scholar
  7. 7.
    Deller A (1987) Die Sicherstellung von Ventilation und Oxygenierung bei speziellen diagnostischen und therapeutischen Eingriffen an Larynx und Trachea. Klinische Anaesthesiologie und Intensivtherapie, vol 35. Anaesthesie für Operation im Kopfbereich. Springer, Berlin Heidelberg New York, pp 212–221Google Scholar
  8. 8.
    Eisler K, Hipp R, Nußer H, Schmeißer K (1986) Zur Problematik von Laserchirurgie und Anaesthesie. Anaesthesist 35 748–750Google Scholar
  9. 9.
    Eriksson I, Sjöstrand U (1974) High-frequency positive-pressure ventilation (HFPPV) during laryngoscopy. Opusc Med 19:278–286Google Scholar
  10. 10.
    Eriksson I, Sjöstrand U (1977) A clinical evaluation of highfrequency positive pressure ventilation (HFPPV) in laryngoscopy under general anaesthesia. Acta Anaesth Scand [Suppl] 64:101–110Google Scholar
  11. 11.
    Gabriel W (1979) Entwicklung der Allgemeinanaesthesie bei endolaryngealen Eingriffen. Prakt Anaesth 14:257–261Google Scholar
  12. 12.
    Heine P, Axlansen M (1988) Anaesthesie und Laserchirurgie im Hals-Nasen-Ohrenbereich. Anaesthesist 37:10–18Google Scholar
  13. 13.
    Hermens JM, Bennett MJ, Hirshman CA (1983) Anesthesia for laser surgery. Anesth Analg 62:218–229Google Scholar
  14. 14.
    Hirlinger WK, Sigg O, Mehrkens HH, Deller A (1983) Erfahrungen mit der High-Frequency-Jet-Ventilation bei Eingriffen am Kehlkopf und an der Trachea. Anaesth Intensivther Notfallmed 18:243–249Google Scholar
  15. 15.
    Klain M, Keszler H (1983) Transtracheal high frequency jet ventilation prevents aspiration. Crit Care Med 11:170–171Google Scholar
  16. 16.
    Ossoff RH (1989) Laser safety in otolaryngology — head and neck surgery. Anesthetic and educational considerations for laryngeal surgery. Laryngoscope 99:1–26Google Scholar
  17. 17.
    Soder CM, Haight J, Fredrickson JL, Scott AA (1980) Mechanical ventilation during laryngeal surgery: an evaluation of the Carden tube. Can Anaesth Soc J 27:111–116Google Scholar
  18. 18.
    Sosis M (1989) Anesthesia for laser surgery. Voice 3: 163–174Google Scholar
  19. 19.
    Sosis MB (1990) Airway fire during CO2 laser surgery using a Xomed laser endotracheal tube. Anesthesiology 72:747–749Google Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • A. Aloy
    • 1
  • M. Schachner
    • 1
  • W. Caucura
    • 2
  1. 1.Department of AnesthesiologyUniversity of ViennaViennaAustria
  2. 2.First Department of OtorhinolaryngologyUniversity of ViennaViennaAustria

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