PubMed · 475035
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P Stiffel, S R Hameroff. 1979. A modified technique for transtracheal anesthesia.. https://doi.org/10.1097/00000542-197909000-00024
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An eight year old girl who probably inhaled gastric contents during surgery for cleft palate repair was ventilated for 10 days in the post-operative recovery area on board the Mercy Ship Anastasis with pulse oximetry as the only monitor of oxygenation. She walked off the ship on the seventeenth day.
A capacitive sensor was tested for its suitability for measuring relative humidity in an anaesthetic gas circuit. The valvo sensor PH1 was tested using various different anaesthetic gas mixtures. Measuring accuracy was influenced neither by such volatile anaesthetics as isoflurane and halothane, nor by oxygen or nitrous oxide. The response time of the sensor depends on its position within the gas, and in the most favourable case is about 3 minutes. The sensor is readily incorporated within an existing gas circuit. The linearity of the characteristic curve must be corrected by external electronic compensation to avoid measuring problems in the lower humidity range.
Laser surgery can be performed using either endotracheal intubation, apnoea or jet ventilation. For operations performed under endotracheal intubation the same technical rules apply as for any other type of anaesthesia. To facilitate intubation a special laser tube is required. The Mallinckrodt Laser-Flex Tracheal Tube has the best physical qualities of all endotracheal catheters available commercially. Aspiration prophylaxis using ranitidin and metoclopramide is recommended for procedures under apnoea or using jet ventilation. For monitoring purposes during jet ventilation or procedures under apnoea, transcutaneous oximetry, ECG recording as well as non-invasive blood pressure measurements at short intervals is mandatory. In addition video monitoring is desirable to allow visual anaesthesiological surveillance of the larynx. The jet ventilator must meet established standards; the option must be available to survey inspiratory peak pressure and end-exspiratory pressure as well as the setting of appropriate alarm limits.