Zadrbilek E, Draxler V, Riegler R, Höfler H
Anaesthesist. 1981 Apr;30(4):191-5.
This is a report on a technique which provides an unimpeded access to the operating field during laryngoscopy and laser microsurgery of the larynx. Under barbiturate-induced neuroleptanaesthesia and relaxation with alcuronium 18 patients were jet-ventilated with nitrous oxide and oxygen. The gas mixture was delivered via an automatic injection ventilator (Injection-Timer, Storz) connected to a short endotracheal tube (Injectoflex, Rüsch - a modified Carden tube). Arterial blood sampling was carried out during the whole procedure. In all patients the recommended technique provided adequate alveolar ventilation with minimal metabolic disturbances; the partial pressures of oxygen exceeded the standard values in all cases. Moderate circulatory alterations were observed. Clinical experience with the anaesthetic technique is presented and the advantages of the modified tube compared with the original Carden tube and former devices for jet ventilation during laryngoscopy are described.