Peroral endoscopies using intravenous anesthesia and high-frequency ventilation.

Peroral endoscopies and elective or emergency surgery must often be performed in the airway of patients in poor physical condition. This retrospective review of 600 patients undergoing various surgical procedures found that 194 were ASA physical status groups III or IV, with various abnormalities affecting the cardiorespiratory or central and peripheral nervous systems. These patients received iv anesthesia using short-acting drugs, to guarantee rapid postoperative recovery. All were intraoperatively ventilated with either high-frequency positive-pressure ventilation or high-frequency jet ventilation. Both techniques proved effective, even in patients with upper airway obstruction. In combination with CO2 laser removal of tumors of the glottic region, high-frequency ventilation may prevent the need for emergency tracheotomies.