Anesthetic Management in Laryngeal Framework Surgery

Abstract

Laryngeal framework surgery results in changes to the form, position, and orientation of the laryngeal framework（cartilage and joints）and indirectly modifies vocal cord position and tension. At our hospital, the anesthetic management of laryngeal framework surgery involves procedural monitored anesthesia care（MAC）. Also called conscious sedation, MAC is a preplanned procedure whereby the patient receives local anesthesia combined with sedation and analgesia. Speech testing can be performed intraoperatively and the patient can be reassured to relieve mental stress. However, we must pay attention to the risk of respiratory depression and the longer time for return of complete arousal compared with local anesthesia alone.

In adequate anesthetic management, surgeons require good speech testing and ease of operation ensured by patients’ comfort. We therefore calculate predicted plasma concentrations of analgesics and sedatives and adjust the doses as needed. It is also important that as anesthesiologists we communicate with surgeons intraoperatively to achieve the anesthetic management goals they require.