O'Donnell J, Williams C J, Rosen C A, Sonbolian N
University of Pittsburgh, School of Nursing, PA 15261, USA.
CRNA. 1998 May;9(2):67-76.
Technological advances have greatly improved the management of the patient undergoing microlaryngeal surgery. The use of a laser, high frequency jet ventilation (HFJV), total intravenous anesthetic techniques (TIVA), and specially designed endotracheal tubes (Xomed Hunsaker Mon-Jet ventilation tube [Xomed Surgical Products, Jacksonville, FL]) are recognized as cutting edge approaches to the management of these cases. The use of high technology adjuncts requires considerable skill and knowledge from the perspective of the anesthesia provider. This case report describes an approach to anesthetic management for a patient with a history of achondroplastic dwarfism having laser excision of bilateral vocal cord granulomas. Further increasing the complexity of the case was the surgical use of an autogenous tissue glue, which required a period of 'airway silence' during the application process.
技术进步极大地改善了接受显微喉镜手术患者的管理。激光、高频喷射通气（HFJV）、全静脉麻醉技术（TIVA）以及专门设计的气管内导管（Xomed Hunsaker Mon-Jet通气导管 [Xomed Surgical Products，杰克逊维尔，佛罗里达州]）的使用被认为是处理这些病例的前沿方法。从麻醉提供者的角度来看，使用高科技辅助设备需要相当的技能和知识。本病例报告描述了一名有软骨发育不全性侏儒症病史的患者在接受双侧声带肉芽肿激光切除时的麻醉管理方法。手术中使用自体组织胶水进一步增加了病例的复杂性，因为在应用过程中需要一段时间的“气道安静”。
