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Ventilatory complications of carbon dioxide laser laryngeal surgery
K Cozine1, J G Stone, S Shulman
1Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY.
Study Objective:
To evaluate complications associated with ventilatory techniques accompanying endolaryngeal carbon dioxide laser surgery.
Design:
Retrospective survey of the Society of Academic Anesthesia Chairmen.
Setting:
Operating room at an urban medical center.
Patients:
Data from 15,701 patients were analyzed.
Measurements And Main Results:
Twenty-six percent of patients were ventilated with Venturi jet ventilation and the rest through an endotracheal tube. Reported complications were classified as ventilation related and ventilation unrelated, as well as by severity. A total of 49 complications occurred in the Venturi jet group (1.2%). Of these complications, 24 were ventilation related (0.58%) and 18 were serious or life threatening (0.43%). There were no deaths in this group. Ventilation through an endotracheal tube was associated with a lower frequency of overall complications (0.36%), ventilation-related complications (0.15%), serious or life-threatening complications (0.15%), and serious or life-threatening ventilation-related complications (0.11%) (p less than 0.001). However, there were eight airway fires in this latter group, one resulting in a fatality.
Conclusions:
No clear choice of ventilatory technique is supported by this survey, but teamwork and experience give the best results.