Summary and Conclusion
Thirty patients received general anaesthesia for forty intralaryngeal operations using a laser beam. The essential requirements for the anaesthetic management are:
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(1)
Anaesthetic agents should be non-flammable.
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(2)
Small diameter red rubber cuffed tracheal tubes provide maximum working space for the surgeon, facilitate controlled ventilation and minimize the explosion hazard of anaesthetic gases in the vicinity of the laser beam.
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(3)
Continuous muscle relaxation of head and neck and of laryngeal muscles facilitates the instrumentation and lasing of lesions of vocal cords which are thus rendered fixed and immobile.
Preventive measures must be taken against accidental exposure to the laser beam of normal tissues of the patient and of personnel in the operating room.
Résumé
Sous anesthésie générate trente malades ont subi une chirurgie du larynx avec emploi du Laser. Après induction au Thiopentone et Succinylcholine, les malades furent intubés avec un tube de caoutchouc de petit calibre (16 à 22 Fr) à ballonnet. L’intubation nous a permis d’une part d’assurer une ventilation adéquate et d’autre part de diminuer les dangers d’ignition des gaz anesthésiques au voisinage des rayons Laser.
L’anesthésie fut maintenue avec 70 pour cent de Protoxyde d’Azote supplémenté de Fentanyl ou d’Halothane. Les malades ont été maintenus curarisés afin d’éliminer des mouvements du cou, de la tête ou de la musculature laryngée.
Durant ces interventions tout le personnel doit porter des lunettes de sécurité afin de se protéger la cornée contre les réflections des rayons sur les instruments métalliques.
Cette technique d’anesthésie ainsi que les mesures de sécurité utilisées ont donné satisfaction.
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Konchigeri, H.N., Shaker, M.H. Anaesthesia for intra-laryngeal laser surgery. Canad. Anaesth. Soc. J. 21, 343–349 (1974). https://doi.org/10.1007/BF03005740
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DOI: https://doi.org/10.1007/BF03005740