Clinical Laser/Light Applications in Anesthesiology Practice
Lasers in surgery and medicine have evolved into a specialized area with increasing use and innovative techniques requiring anesthesia providers to be familiar with the historical, technical, and procedural aspects of laser applications. Lasers applications in surgery include a variety of procedures with various laser types and specific anesthetic considerations. Currently, anesthesia providers commonly encounter use of lasers in many procedures including airway surgery, cutaneous and cosmetic surgeries, urologic, endoscopic and ophthalmology procedures. Anesthesia for procedures involving laser use in specialized patient populations such as pediatrics and obstetrics requires the anesthesia provider to be familiar with the procedure and special needs of the patient. Development of an anesthetic plan that is safe and satisfactory to the surgeon and patient necessitates knowledge of the procedure and patient characteristics. Laser applications for surgery are widespread and include excisions of dermatologic lesions, treatment of laryngeal lesions, treatment of prostatic hypertrophy, Barrett’s esophagus and cataracts. Use of laser in cosmetic and cutaneous procedures is generally well tolerated with monitored anesthesia care supplemented with topical or local anesthesia. Laser use in prosthetic reduction surgery is common and often patients are elderly presenting with multiple co-morbidities influencing choice of anesthetic technique. With the use of lasers in the operating becoming more common in recent years, awareness and adherence against health hazards to both the patient and personnel are essential. Laser safety includes vigilance on the part of the anesthesia provider to prevent laser induced fires, avoid eye injury and burns, as well as, prevent electrical hazards. Procedures involving lasers and the airway represent a special challenge to the anesthesia provider including risk of airway fire, aspiration, injury, and inadequate ventilation and oxygenation. As laser technology continues to evolve in the fields of medicine and surgery benefits to the patient as it relates to anesthesia are apparent in some areas and require further study in others. Laser safety programs are required nationally in all hospitals and office based surgical facilities using lasers.
KeywordsLaser applications in surgery Laser use in the operating room Laser use in procedural areas Anesthesia considerations for laser use Laser use in endoscopy Laser use in cataract surgery Airway surgery and lasers Airway fire Protective eyewear for laser use Laser safety checklist
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