ABSTRACT
Anaesthesia for operations on the airway are unique in that both the surgeon and anaesthetist are working in the same area. Anaesthetic techniques can be broadly classified into two groups. ‘Closed’ systems in which a cuffed tracheal tube is employed with protection of the lower airway but the potential for laser-related problems. In ‘open’ systems, where no tube is used, ventilation is achieved through spontaneous breathing or jet ventilation techniques. Very mobile lesions, such as multiple large vocal cord polyps or significant papillomatous lesions, may cause partial airway obstruction following induction of anaesthesia, but total airway obstruction is extremely uncommon. Open systems for anaesthetic management include jet ventilation techniques, intermittent apnoea techniques and spontaneous ventilation techniques. If the depth of anaesthesia is too great, the patient may become apnoeic with cardiovascular instability. Closed systems have no leak into the outside environment or entrainment of air into the system and employ a tracheal tube with an inflatable cuff.
