Anesthesia Technic for Simple Operation around the Vocal Cords / 대한마취과학회지

ABSTRACT

Anestheiologists face the difficulty of mainatining patent airway in performing anesthesia for surgery around vocal cords. Because the simplicity of the above operation, the surgeons and patients tend to avoid the preparatory tracheostomy which is a safe way of maintaining anesthesia. The difficulties and problems occurring during anesthesia without performing tracheotomy were considered. The problems were; 1) Operating field interfering the anesthetic procedures. 2) Possibility of aspiration of blood during operation. 3) Apnea time of surgery limiting to 5 minutes or less. 4) Repeated intubation for anesthesic procedure. Apneic insufflation method was modified by spontaneous respiration. The tehnic was; the endotrachel tube was removed after induction of general anesthesia when patients spontaneous respiration regained Then suction catheter, 12 fr. size, was inserted to above the carina of trachea. Next, for ventilation, oxygen with high flow rate (9~10 L/Min) was insufflated in trachea through the catheter. This insufflation of high flow oxygen brought continuous positive pressure in trachea, also it acted effectively as PEEP (positive end expiratory pressure) effect .and provided protective mechanism from the aspiration. The addition of potent anesthetics such as halothane and ether insufflating oxygen allowed the control of depth of anestheia effectively. With this insufflation technic, two cases of excision of singers nodule were performed uneventfully.