Anesthesia considerations for laser surgery include managing hazards from atmospheric contamination, laser-tissue interactions, and endotracheal tube fires. Various laser wavelengths are used in procedures like dermatology and ophthalmology. Endotracheal tubes must be protected to prevent fires, and techniques like intermittent apnea and helium-oxygen mixtures reduce risks. Post-operative monitoring is also important due to potential complications from the laser effects. Safety policies and protocols help minimize risks from laser use in surgery.

3. “ Never are cooperation and communication between surgeon and anesthesiologist more important than during head and neck surgery.” Morgan, Clinical Anesthesiology

6. Laser system components

7. Laser system component LIGHT GUIDE

10. Common used Laser lights Laser media Color Wavelength (nm) Typical application Carbon dioxide Far infrared 10,600 General, cutting Ruby Red 694 Tattoos, nevi KTP:YAG Green 532 General, pigmented lesions Argon Green 514 Vascular, pigmented lesions Xenon fluoride Ultraviolet 351 Cornea, angioplasty

20. Various endotracheal tubes for laser airway surgery Type of tube Advantages Disadvantages Polyvinyl chloride Inexpensive, nonreflective Low melting point, highly combustible Red rubber Puncture-resistant, maintains structure, nonreflective Highly combustible Silicone rubber Nonreflective Combustible, turns to toxic ash Metal Combustion-resistant, kink-resistant Thick-walled flammable cuff, transfers heat, reflects laser, cumbersome

22. Cuff wrapping technique methylene blue stained saline instead of air

29. Lasertubus

31. LASER-TRACH® Laser Resistant Tracheal Tube For use with CO2 and KTP Lasers • Clinically proven red rubber material • Unique embossed copper foil diffuses laser energy • Atraumatic outer covering