Anesthetic Management with High Frequency Jet Ventilation for Laryngotracheal Procedures: A Retrospective Study

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Prok Laosuwan
Warita Chaiarundeekul
Phloenphit Chailit
Kanokon Techasuntornkul

Abstract

Background: Good surgical exposure and unhindered
laryngeal area are an ideal component in tracheolaryngeal
surgery. High frequency jet ventilation (HFJV) has been
developed over decades for these procedures. The
safety of this technique was proved. The aim of this study
was to report the success rate and safety of anesthesia
with HFJV technique in a tertiary university hospital in
Thailand.
Methods: We reviewed both elective and emergency
cases of laryngotracheal procedures which were
under general anesthesia with HFJV technique at the
Ear-Nose-Throat operating theater of King Chulalongkorn
Memorial Hospital between August 2013 to March 2016.
The characteristics, details of anesthesia technique, and
surgery immediate outcomes were examined.
Results: A total of 45 cases in 43 patients were included
to the case series. There were 31 male and 14 female patients. The mean age was 45 years old (range 11 to 84
years old). Common symptoms were dyspnea (40%) and
hoarseness (32.6%). The common diagnosis was
subglottic stenosis which needed reduction of stenosis
with or without laser assistance. All of the cases received
total intravenous anesthesia (TIVA) during HFJV. Mean
operation time was 38.7 minutes (range 15 to 115
minutes). Complications were hypoxia (4.4%), failed HFJV
(2.2%) due to outflow obstruction and airway fire (2.2%).
No death or barotrauma was reported.
Conclusion: Anesthesia with HFJV in most of patients
who underwent laryngotracheal procedures was safe and
successful with a small amount of minor adverse
outcomes.

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