Deepanshu D1, Naresh P2, Nitika G1* and Tanvir S1
1Department of Anesthesia, PGIMER, India
2Department of Otorhinolaryngology, PGIMER, India
Transoral Robotic Surgery (TORS) have become increasingly popular for removal of pharyngeal and laryngeal cancers with objective to improve functional and aesthetic outcomes. Feyh- Kastenbauer retractor (FK retractor) is one such routinely used retractors during TORS. The setting up of this retractor has been seen to be accompanied by hemodynamic fluctuations. This prospective observational study was carried in 30 patients undergoing TORS. All patients were administered general anesthesia using pre-defined ana-esthesia protocol. Primary outcome was to compare hemodynamic fluctuations following endotracheal intubation with that after FK retractor insertion. Any requirement of bolus dose of sevoflurane and fentanyl were recorded in response to hemodynamic fluctuations were recorded in secondary outcomes. There was no statistically significant increase in mean heart rate, systolic, diastolic and mean arterial blood pressure from baseline to endotracheal intubation and following retractor insertion (p-0.810, p-0.2, p-0.6, p-0.3 respectively). On subgroup analysis, hypertensive patients reported greater rise in blood pressure following 2 min post FK retractor insertion compared to non-hypertensive patients (p=0.03). Out of 30 patients, 5 patients required bolus dose of sevoflurane. FK retractor insertion had comparable hemodynamic response as endotracheal intubation during Transoral Robotic Surgery. Hypertensive patients showed rise in blood pressure at both endotracheal intubation and at FK retractor insertion.
Feyh-Kastenbauer retractor; Transoral Robotic Surgery; Hemodynamic changes
Deepanshu D, Naresh P, Nitika G, Tanvir S. A Preliminary Feasibility Study on Hemodynamic Changes Following Feyh-Kastenbauer Retractor Insertion During Transoral Robotic Surgeries: Are They Worse Than Endotracheal Intubation?. Am J Otolaryngol Head Neck Surg. 2023; 6(1): 1223.