Safe Use of Flammable Endotracheal Tubes During Anesthesia for Laryngeal Laser Surgery-Report of 1024 Cases and a Brief Literature Review.

Abstract

One of the major concerns in laryngeal laser surgery is the risk of airway fire. The introduction ofwrapped tubes and metal tubes has reduced the fire hazards. However, these tubes are expensive and do not provide convenient access to the surgical field. There are few laboratory studies addressing the resistance of polyvinylchloride tubes against ignition in the given circumstances. Nevertheless, its safety should be approved in clinical practices. This retrospective studyevaluated the airway management on 1024 patients undergoing laryngeal laser surgery. The data collection included the information about the type of endotracheal tube (ETT), mode of ventilation, and airway hazards (e.g., tube ignition). Polyvinylchloride tubes and conventional positive pressure ventilation was applied for most of the patients (84.1%). The tube cuff was pierced with laser beam in 22 cases (2.5%). However, there was no case of ETT ignition or airway fire. Polyvinylchloride tubes can be safely used in this subset of surgeries pending meticulous attention to the safety recommendations.