Anesthesia:Laser Surgery of Throat

Putting a patient to sleep for laser surgery is a great challenge for the anesthetist.Skilled anaesthesia is required in ENT surgery as both the surgeon and the anaesthetist often share the same field.Lasers used for the surgeries in larynx and oral cavity can damage the endotracheal tube by excessive heat generation and start a fire. Inspired O2 concentration should be low by 21-30%. Nitrous oxide supports combustion and should be avoided.The endotracheal tube is wrapped by a thin aluminium foil to prevent damage by the laser beam.Saline soaked pledgets should be placed in the airway to reduce the thermal damage to surrounding structures.The eyses of the patient is protected by placing moist gauze.