What Is the Safest Endotracheal Tube for Nd-YAG Laser Surgery????A Comparative Study

Sosis, Mitchel B.

doi:10.1213/00000539-198912000-00020

Cited by 23 publications

(8 citation statements)

References 6 publications

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“…Commercially available laser-resistant tracheal tubes are expensive and their cuff is inflammable. Use of a metal endotracheal tube does not imply absolute protection from ignition as 50 W of Nd:YAG beam focused to 0.68 mm ignited a laser flex in 6 s 6. Use of low FiO 2 (<30%) in lung with poor functional capacity poses a specific risk during laser surgery of a lung tumour as occurred in our case.…”

Section: Discussionmentioning

confidence: 71%

Use of i-gel for laser ablation of a bronchial lesion

2017

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The use of laser for airway lesions requires airway management. Usual options include special laser-resistant endotracheal tubes. The use of supraglottic devices have been described in the literature. Laryngeal mask airway carries the risk of cuff damage during the use of laser. i-gel is made of thermoplastic material and does not require air inflation and thus potentially reduce the risk of cuff rupture. i-gel use in laser surgeries has not been described in the literature. We present successful airway management in laser surgery for bronchial tumour using i-gel.

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Section: Discussionmentioning

confidence: 71%

Use of i-gel for laser ablation of a bronchial lesion

2017

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“…A larger diameter tube is also available with two cuffs, in case the upper one is hit with a laser pulse accidentally leading to deflation. These tubes can also combust under certain circumstances although they are very resistant to this in practice (13) (Figures 12 and 13). Other types of endotracheal tube including those made of aluminumized plastic are available with varying degrees of laser resistance.…”

Section: Airway Considerationsmentioning

confidence: 99%

Anesthesia for laser surgery of the airway in children

Best

2009

Pediatric Anesthesia

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SummaryAnesthesia for laser surgery in children carries a number of particular challenges and pitfalls. The anesthetist must be aware not only of the problems of anesthetizing a patient with a potentially compromised airway but also of how to maintain homeostasis when surgery is taking place, as procedures may make a bad situation temporarily worse. Personnel must also be very aware of the benefits and dangers of medical lasers, and what safety precautions must be taken to ensure their proper use. This section will deal with the properties of lasers, how and why they are used, and a description of how these procedures are carried out in our own institution.

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“…32 This same research group and another demonstrated that none of the three commonly used ETT materials-PVC, red rubber, and silicone-are safe when exposed to Nd:YAG laser energies. 33,34 Various strategies for the protection of ETTs from laser-strike damage have been evolving since the 1970s. Standard ETTs may be rendered more resistant to ignition by wrapping them with protective material, or the alternative is to use laser-resistant tracheal tubes (LRTTs), which are ETTs prefabricated with protective layering.…”

mentioning

confidence: 99%

Anesthetic Challenges During Laser Surgery of the Larynx Part 2. Operating Room Fire

Marinov

Belitova

Popov³

et al. 2019

International Bulletin of Otorhinolaryngology

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Theoretical basis: Laser is an acronym for light amplification by stimulatedemissionofradiation-a highly collimated beam of photons at a single frequency. Lasers are ubiquitous in the modern world and are increasingly used in the operating room. The Aim of the study is to determine different anesthetic techniques and complications during laser surgery of the larynx. Results: The ignition and propagation of fire requires a triad of components: ignition source, fuel and oxidizer. All parts of the firetriad are ubiquitous in operating room and may be in close proximity of each other during laser surgeries. When laser use is planned, the concentration of inspired oxidizers must be considered. When the surgical site is within or near the airway, coordination between the anesthesia and surgical teams is essential to consider the need for an ETT, which tube type to use, the oxygen enrichment plan, and mode of ventilation. Standard polyvinyl chloride (PVC), red rubber, and silicone ETTs are candidates for use during laser procedures near the airway, but all are ignitable and require protective measures. Conclusion: Lasers are increasingly used in the operating room. Understanding the technology is important to safe anesthetic practice.

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What Is the Safest Endotracheal Tube for Nd-YAG Laser Surgery????A Comparative Study

Cited by 23 publications

References 6 publications

Use of i-gel for laser ablation of a bronchial lesion

Use of i-gel for laser ablation of a bronchial lesion

Anesthesia for laser surgery of the airway in children

Anesthetic Challenges During Laser Surgery of the Larynx Part 2. Operating Room Fire

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