Just wondering...

**FruitcakeLiz** · 09-06-2006, 02:08 PM

After having my wisdom teeth removed under GA, i am wondering how is they anaethatise you if you having max fax surgery?? Becuase surely you can having anything in your mouth?

Funny question i know but it suddently occured to me the other day! And sorry if it's being a bit thick but i'm not at medical school and haven't been lucky enough to see any surgery on w/e or anything!

If anyone could fill me in i'd be interested to know, thanks!

**racheljane** · 09-06-2006, 08:30 PM

Nasotracheal intubation? Hey if that's right I might sound quite clever

(but it probably isn't

)

**Jake** · 09-06-2006, 10:36 PM

I believe you can do a fair amount of max fax with a standard tube. Failing that as racheljane said nasaotracheal intubation or in some cases a tracheostomy can be used.

**FruitcakeLiz** · 11-06-2006, 06:37 PM

Oh yes that makes sense, thanks for that.

**andy2** · 14-06-2006, 12:08 AM

The options for max-fax surgery depend in the surgery planned and the patient - an oral Endotracheal tube can be used, this is usually 'armoured' which allows it to be manouvered without kinking. Nasal intubation is also used and works well but comes with increased risk of epistaxsis. For a lot a work an armoured 'laryngeal mask airway' can be used
(http://www.lmana.com/prod/components/ ) which unlike an ET tube does not require paralysis for insertion. As mentioned above a tracheostomy is another option -and is vital when a large tumour/swelling threatens the upper airway. This is sometimes done under local anaesthetic if the airway is thought likely to be at high risk.

Sharing the airway with surgeons can be a real challenge and demands understanding on both sides -it is one of the things that makes ENT, max-fax and head and neck surgery a challenging area of anaesthesia.