An anesthetic combination best allows for analgesia while enabling patients to respond to vocal commands during medialization thyroplasty, Anesthesia News reports.
Rochester, Minn.-based Mayo Clinic anesthesiologist Megan Hamre, MD, presented the findings of her study at the 70th PostGraduate Assembly in Anesthesia, Dec. 9 to 13, 2016 in New York City.
The procedure was originally done under local anesthesia which caused patient discomfort. It is now done under general anesthesia with extubation during surgery to allow the patient to respond.
Dr. Hamre led researchers in examining 40 consecutive cases of thyroplasty, 39 with and one without arytenoid adduction.
Most (97.5 percent) patients received dexmedetomidine and remifentanil infusions while undergoing arytenoid adduction, while receiving continuous propofol infusions. When physicians needed patients to talk, anesthesiologists stopped dexmedetomidine and propofol temporarily maintaining patients on remifentanil.
The approach requires close communication between the anesthesiologist and the otolaryngologist to coordinate the sedation.
Although the three anesthetics are the most commonly used, they've never been studied together. Dr. Hamre claims they're safe when used simultaneously. No significant adverse events occurred during hospital stays.
Dr. Hamre noted that additional prospective data would validate the findings.