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2 results

  • Chapter 33 - The Airway in Anaesthesia for Transoral Robotic Surgery

  • from Section 2 - Airway Management: Clinical Settings and Subspecialties
  • Edited by Tim Cook, Michael Seltz Kristensen
  • Book:
    Core Topics in Airway Management
    Published online:
    03 October 2020
    Print publication:
    03 December 2020, pp 290-292

  • Summary

    Transoral robotic surgery (TORS) allows resection of otherwise inaccessible pathology. It generates unique challenges to the airway management of the patient due to the shared location of the anaesthetist and the surgeon’s equipment. A close cooperation between the anaesthetic and surgical team is required, for the safe handling of the airway. The anaesthetist needs to be able to employ a variety of airway manoeuvres in order to ensure the airway patency throughout the perioperative and post-operative period. The airway of the TORS patient is characterised by its dynamic nature, as it changes due to the surgery, swelling and bleeding.

  • Chapter 13 - Anesthesia for endoscopic sinus surgery

  • from Section 2 - Anesthesia for nasal, sinus and pituitary surgery
  • Edited by Basem Abdelmalak, John Doyle
  • Book:
    Anesthesia for Otolaryngologic Surgery
    Published online:
    05 November 2012
    Print publication:
    18 October 2012, pp 121-132

  • Summary

    The incidence of difficult airway is higher in patients undergoing ENT surgery and, specifically, in patients undergoing ENT cancer surgery. Even the process of topicalization with local anesthetic can precipitate loss of the airway, as can some of the complications associated with awake intubation (e.g. airway bleeding and laryngospasm). The preoperative interview should also address the possibility of events having occurred since the last anesthetic such as weight gain, laryngeal stenosis from previous airway intervention, airway radiation, facial cosmetic surgery, and worsening temporomandibular joint disorder or rheumatoid arthritis. Prior to awake intubation, premedication is commonly used to reduce secretions, enable adequate topicalization of the airway, reduce the risk of epistaxis, and protect against the risk of aspiration. Depending on the clinical circumstance, intravenous sedation may be useful in allowing the patient to tolerate awake intubation by providing anxiolysis, amnesia, and analgesia.