Tubeless anaesthesia with sevoflurane and propofol in adult laryngeal surgery
| Autor: | Saija Hurme, Hanna S. Illman, Heikki Antila, Reidar Grénman |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Methyl Ethers medicine.medical_specialty Adolescent Sevoflurane Laryngeal Diseases Laryngoplasty medicine Humans Prospective Studies Propofol Aged Monitoring Physiologic Aged 80 and over Inhalation business.industry General Medicine Middle Aged Cannula Surgery Treatment Outcome Otorhinolaryngology Bispectral index Anesthesia Anesthetics Inhalation Breathing Room air distribution Linear Models Female Laser Therapy business Anesthetics Intravenous medicine.drug |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 268(1) |
| ISSN: | 1434-4726 |
| Popis: | The presence of endotracheal intubation tube or jet ventilation cannula can compromise free view and access to operation area in certain endolaryngeal operations. The objective of this prospective study was to test whether adequate level of anaesthesia could be obtained in adults using tubeless sevoflurane inhalation anaesthesia with spontaneous breathing. In 23 ASA 1–2 patients, 31 treatments were included in the study of which 19 were laser-assisted papilloma or other tumour resections and 12 were fascia injection laryngoplasties. Anaesthesia was induced with propofol and maintained by insufflating sevoflurane mixture to the patient’s oropharynx. The adequacy of the anaesthesia level was assessed by monitoring bispectral index, haemodynamic parameters and peripheral oxygen saturation during the anaesthesia. The ENT surgeon estimated operating conditions, whilst the two participating anaesthesiologists assessed the quality of anaesthesia using a 100 mm VAS scale. Sevoflurane contamination in the operating theatre was measured during five treatments. Mean bispectral index was below 40 throughout the operation. Haemodynamic parameters showed only minor changes during the anaesthesia. Both attending anaesthesiologists and operating ENT surgeon were satisfied with the quality of the anaesthesia and operating conditions (VAS 83 ± 15, mean ± SD, range 42–100, and VAS 93 ± 10, range 55–100, respectively). Sevoflurane room air contamination was high in most measured cases. The modification of tubeless inhalation anaesthesia used in this study produced adequate level of anaesthesia with stable haemodynamics and good operating conditions. Sevoflurane contamination can be reduced with more efficient scavenging systems. |
| Databáze: | OpenAIRE |
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