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International Bulletin of Otorhinolaryngology

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

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


Theoretical basis: Laser is an acronym for light amplification by
stimulated emission of radiation-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 fire triad 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.


Laser, operating room fire, protective measures.

Full Text


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