Hemodynamic complications during microlaryngeal surgery

Abstract

Introduction: Successful anesthetic management of microlaryngeal cases requires a high degree of cooperation with the surgeon, a reciprocal understanding of the potential problems, and adequate preparation on both sides to meet the anticipated challenges that may arise. The Aim of the study is to determine the hemodynamic complications during microlaryngeal surgery. Materials and Methods: A 5-year prospective cohort study of 200 patients who underwent microlaryngeal surgery in the Department of ENT Surgery; University Hospital “Queen Giovanna”- ISUL; Medical University-Sofia. All patients were monitored and recorded for: Systolic blood pressure (SBP), Diastolic blood pressure (DBP); heart rate (HR); continuous electrocardiography (ECG). The above parameters were recorded and analyzed at predetermined time intervals: 5-th minute before intubation, every 5 minutes after intubation and 5-th minute after extubation. Results and discussion: Mean systolic blood pressure of the patients during the operation is 147.33 mmHg, mean diastolic blood pressure is 93.5 mmHg and mean pulse rate is 57.64 beats per minute. 49% of the patients have arterial hypertension I grade during the operation, 28% of them are with isolated arterial hypertension and 23% are with normal blood pressure. 40% of the patients had pulse rate between 45-60 beats per minute during putting on the tube of Kleinsasser, 29% of them had pulse rate>60 beats per minute during putting on the tube of Kleinsasser and 31% had pulse rate<45 beats per minute during putting on the tube of Kleinsasser. Conclusion: Microlaryngeal surgery 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.