Rheindorf P
HNO. 1976 Jan;24(1):33-4.
Four essential points exist in the use of narcosis for surgery of the middle ear: 1. In addition to local anesthesia, any method of narcosis for anesthesia with endotracheal intubation is suitable for surgery. 2. Surgical procedures utilizing the operating microscope make immobility of the patient mandatory. 3. Establishment of a relatively bloodless surgical field by special techniques (such as use of local vasoconstrictors or controlled hypotension with ganglionic blocking agents or halothane) can be employed. 4. Altered middle ear pressure by nitrous oxide (causing a rise in pressure by 3-4 cm H20) can impede operative procedures.