Complications of general anesthesia for Nd:YAG laser resection of endobronchial tumors.
We studied the incidence and mechanisms of cardiovascular complications and postoperative respiratory insufficiency associated with GA and Nd:YAG laser endobronchial tumor resection. The records of 73 patients undergoing 87 procedures were reviewed. Preoperative status, anesthetic methods and perioperative complications were analyzed by multiple regression to determine predictors of outcome. Twenty-three percent of patients had greater than 90 percent mainstem bronchus obstruction. Longer serum elimination half-life of relaxant drug was significantly correlated with longer duration of mechanical ventilation after neuromuscular blockade reversal. Cardiovascular complications were noted in 24 procedures and often required therapeutic intervention. Variables predicting cardiovascular complications included longer duration of GA and increasing age. Perioperative respiratory and cardiovascular complications are common after GA for Nd: YAG laser resection. Short-acting neuromuscular relaxants, careful assessment prior to postoperative extubation, limiting duration of GA and cardiovascular monitoring are recommended when implementing GA for Nd: YAG laser resection of endobronchial tumors.
Hanowell
L H
LH
Department of Anesthesiology, University of California Davis Medical Center, Sacramento 95616.
Martin
W R
WR
Savelle
J E
JE
Foppiano
L E
LE
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects*; D001984:Bronchial Neoplasms / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012044:Regression Analysis; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology*