Anesthesia for Carbon Dioxide Laser Microsurgery of the Larynx

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Abstract
Jet ventilation via the Sanders injector during intravenous general anesthesia provides excellent operative conditions for CO2 laser microsurgery of the larynx. This technique, which includes complete muscle relaxation, is superior to traditional methods of anesthesia because the endotracheal tube is eliminated, thus improving the surgical field and reducing burn hazards owing to ignition of the tube. The laryngoscope has been modified to carry multiple ports into which a 14-gauge needle is inserted and the tip advanced just distal to the vocal cords. This needle is securely attached to the injector and pressure from the oxygen source is adjusted according to the patient's build and total compliance. Satisfactory arterial blood gases, superb operating conditions, safety, and rapid awakening make this the method of choice for most patients.