A technic for administering balanced anesthesia to patients undergoing microlaryngeal surgical procedures utilizes a special short (21/2 in.) endotracheal tube and a high-flow nitrous oxide-oxygen blender connected with a pressure-reducing valve and blowgun. The operating laryngoscope blade is positioned while the surgeon views the operating field through a binocular microscope.
The endotracheal tube is placed under direct vision, with the patient asleep and paralyzed, below the vocal cords and anchored in position by cuff inflation. During anesthesia, the patient remains paralyzed, is given intravenous narcotics, and is ventilated by intermittent bursts of oxygen-nitrous oxide mixtures from the jet. Obstruction of the surgeon's view is minimal, being only by the 1/10-in. jet tube and the 1/16-in. inflating tube, both of which lie in the posterior commissure of the larynx.