[Ventilation with metallic tubes in CO2 laser surgery of the larynx]

One of the risks of laryngeal laser surgery is the ignition of the disposable plastic endotracheal tubes used for ventilation. In 1985, Hunton and Oswal (Anaesthesia, 40: 1210, 1985) developed a metallic tube which is now available in France. In this study, the tube has been tested on 30 patients undergoing this type of surgery. The tube was sterilized in glutaraldehyde before re-using it. There never was any problem with placing the tube and surgical conditions were satisfactory. There was neither incident due to the laser, nor any difficulties with the use of high-frequency jet-ventilation. The blood gas values were satisfactory (mean PaO2: 19.4 +/- 4.2 kPa; mean PaCO2 5.0 +/- 0.46 kPa). After a use in 30 consecutive patients, the tube was not damaged. The advantages and disadvantages of this tube are discussed, considering the other types of special laser surgery endotracheal tubes. This metallic tube is not flammable, can be used several times, occupies only a small space and does not hurt tissues. Moreover, it is cheaper than disposable tubes when the price is calculated per patient. It would therefore seem that Hunton and Oswal's metallic tube, used with high-frequency jet-ventilation is a good alternative for tubes used today.