Jeckström W, Wawersik J, Werner J A
Klinik für Anästhesiologie und Operative Intensivmedizin, Christian-Albrechts-Universität Kiel.
HNO. 1992 Jan;40(1):28-32.
Laser surgery can be performed using either endotracheal intubation, apnoea or jet ventilation. For operations performed under endotracheal intubation the same technical rules apply as for any other type of anaesthesia. To facilitate intubation a special laser tube is required. The Mallinckrodt Laser-Flex Tracheal Tube has the best physical qualities of all endotracheal catheters available commercially. Aspiration prophylaxis using ranitidin and metoclopramide is recommended for procedures under apnoea or using jet ventilation. For monitoring purposes during jet ventilation or procedures under apnoea, transcutaneous oximetry, ECG recording as well as non-invasive blood pressure measurements at short intervals is mandatory. In addition video monitoring is desirable to allow visual anaesthesiological surveillance of the larynx. The jet ventilator must meet established standards; the option must be available to survey inspiratory peak pressure and end-exspiratory pressure as well as the setting of appropriate alarm limits.
激光手术可通过气管内插管、呼吸暂停或喷射通气来进行。对于在气管内插管下进行的手术,适用与任何其他类型麻醉相同的技术规则。为便于插管,需要一根特殊的激光管。 Mallinckrodt激光柔性气管导管在所有市售气管导管中具有最佳的物理性能。对于呼吸暂停或使用喷射通气的手术,建议使用雷尼替丁和甲氧氯普胺预防误吸。在喷射通气或呼吸暂停手术期间进行监测时,必须每隔短时间进行经皮血氧饱和度测定、心电图记录以及无创血压测量。此外,希望进行视频监测,以便对喉部进行视觉麻醉监测。喷射呼吸机必须符合既定标准;必须能够查看吸气峰压和呼气末压以及设置适当的报警极限。