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International Bulletin of Otorhinolaryngology

Hemodynamic Complications During Laser Surgery of the Larynx

Ts. Marinov, M. Belitova, T. Popov, N. Nizamova, J. Rangachev, D. Popova

Abstract

Introduction: Laser surgery of the larynx offers several advantages
over conventional surgical methods, including a bloodless operative
field and microscopic precision. However, the anesthetist faces special
issues in the management of these patients. The Aim of the study
is to determine the hemodynamic complications during laser surgery
of the larynx. Materials and Methods: A 2-year prospective cohort
study of 50 patients who underwent laser microsurgery of the larynx
in the Department of ENT Surgery; University Hospital „Queen
Giovanna”- ISUL; Medical University-Sofia. We used total IV
anesthesia. All patients were monitored and recorded for: Peripheral
Capillary Oxygen Saturation (SpO2); Systolic blood pressure (SBP),
Diastolic blood pressure (DBP); heart rate (HR); continuous electrocardiography
(ECG). Results and discussion: The mean age of the
patients is 61.04 years. 8% of them are females and 92% are males.
According to anesthesia risk assessment 4% of the patients are with
ASA 1 class, 30% of them are with ASA 2 class, 64% are with ASA
3 class and 2% are with ASA 4 class. The mean duration of operation
is 57.06 minutes. Mean systolic blood pressure of the patients
is 141.22 mmHg, mean diastolic blood pressure is 86.2 mmHg and
mean pulse rate is 60.94 beats per minute. 44% of the patients have
arterial hypertension I grade, 24% of them are with isolated arterial
hypertension and 32% are with normal blood pressure. 44% of the
patients had pulse rate between 45-60 beats per minute during putting
on the tube of Kleinsasser, 32% of them had pulse rate>60 beats per
minute during putting on the tube of Kleinsasser and 28% had pulse
rate<45 beats per minute during putting on the tube of Kleinsasser.
Conclusion: Laser surgery of the larynx is specific kind of surgery
which is characterized by hypertensive hemodynamic. There is a risk
of severe bradycardia after putting on the tube of Kleinsasser which
can cause hemodynamic instability and even cardiac arrest if not corrected
immediately.

Keywords

Laser surgery, hypertensive hemodynamic, bradycardia

Full Text


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DOI: http://dx.doi.org/10.14748/orl.v15i3.6694

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