Anesthetic Challenges During Laser Surgery of the Larynx Part 2. Operating Room Fire

Abstract

Theoretical basis: Laser is an acronym for light amplification by stimulated emission of radiation-a highly collimated beam of photons at a single frequency. Lasers are ubiquitous in the modern world and are increasingly used in the operating room. The Aim of the study is to determine different anesthetic techniques and complications during laser surgery of the larynx. Results: The ignition and propagation of fire requires a triad of components: ignition source, fuel and oxidizer. All parts of the fire triad are ubiquitous in operating room and may be in close proximity of each other during laser surgeries. When laser use is planned, the concentration of inspired oxidizers must be considered. When the surgical site is within or near the airway, coordination between the anesthesia and surgical teams is essential to consider the need for an ETT, which tube type to use, the oxygen enrichment plan, and mode of ventilation. Standard polyvinyl chloride (PVC), red rubber, and silicone ETTs are candidates for use during laser procedures near the airway, but all are ignitable and require protective measures. Conclusion: Lasers are increasingly used in the operating room. Understanding the technology is important to safe anesthetic practice.