[Cervical peridural anesthesia for carcinologic surgery of the larynx. 10 cases]

Cervical peridural anesthesia was associated to a general anesthesia with controlled ventilation in ten patients undergoing laryngectomy for cancer. All the patients (middle age 57 years) suffered chronic bronchopneumopathy. The cervical peridural approach is realized by puncture at the level C6-C7 with setting of a peridural catheter. After a test dose, a total volume of 18 ml of bupivacaïne at 0.33% is injected. Reinjections of nine ml of the anesthetic solution are realized after a mean delay 200 min. After induction with thiopental and pancuronium bromide, narcosis is maintained by N2O/O2, 0.5/0.5 associated to 0.5% halothane. The mean operating time was four hours and ten minutes. The anesthetic block obtained stretches from C2 to D4, after a mean delay 22 +/- 7 min. Analgesia is satisfying. Little changes occurs in hemodynamic state, except an almost constant bradycardia. Bleeding stay in range of laryngectomies. The awakening is immediate; the post-operative evolution is simple. No complication tied to the anesthesia has been observed.