Monday, February 11, 2019

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This protocol was last updated before 2020

Modified Operative Note

Procedure: Flexible Transnasal KTP lasing (KTP V,1) of glottic larynx (total 66 J, 30 watts, 15 msed pulses, 2 pps)

Anesthesia: Premedication with 1 mg glycopyrrolate orally 1 1/2 hours before the procedure 

  • Bilateral superior laryngeal blocks (dental carpules 2% with 1:100,000, 1cc to each side) done in preholding area (see: Superior Laryngeal Nerve Blocks Instruction Video), IV 3 mg midazolam, topical 4% lidocaine with 1% phenyephrine spray x 2 to left nostril then packed with 2 neurosurgical cottonoids
    • KTP V,1
    • 26 joules to left vocal cord
    • 40 joules to right vocal cord
  • Plan targetted in clinic KTP laser transnasal laryngoscopy in 3 months preop with glycopyrrolate 1 mg po 1 1/2 hour before
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