Hazards associated with laser surgery in the airway of the horse: implications for the anesthetic management.

Over the past two decades, the use of lasers has become an integral part of upper airway surgery in the horse as it allows for more precise tissue dissection, produces less bleeding and tissue trauma, and reduces the incidence of postoperative complications. Nevertheless, laser surgery in the anesthetized horse also holds novel hazards for patient and operating room personnel alike. Certainly laser surgery constitutes a challenge as operation of a high-energy temperature source in the airway, often in vicinity of the endotracheal tube, bears the risk of accidental tube ignition and subsequent airway fire. This danger is of particular concern during inhalation anesthesia, when patients breathe oxygen-rich gas mixtures that readily support tube combustion. Therefore laser surgery in the respiratory tract requires a detailed pre- and intraoperative communication and cooperation between surgeon and anesthesiologist, and a specific anesthetic management tailored to the individual surgical procedure and laser instrument being used. By following prescribed safety procedures and precautions, and employing appropriate measures in an emergency situation, both surgeon and anesthesiologist can markedly reduce the risk of potentially life threatening complications.