Endotracheal tube safety during laser surgery.

The most morbid complication of laryngeal laser surgery is an endotracheal tube fire. The purposes of this study were to determine the efficiency of saline solution-soaked cottonoid pledgets in protecting endotracheal tube cuffs from the laser beam and to evaluate the safety of four commonly used endotracheal tubes. The method involved measurement of perforation times of saline-soaked cottonoid pledgets with controlled variables of air exposure times and laser energy. The second part evaluated the safety and ignition properties of the red rubber, silicone, polyvinyl chloride, and Xomed Laser-Shield tubes by studying their perforation times and ignition properties under controlled oxygen concentrations. The results revealed that saline-soaked pledgets are very efficient in protecting endotracheal tube cuffs. The Laser-Shield tube was the safest one studied. It had the highest ignition threshold of the four tubes tested.