Dexmedetomidine is useful for sedation during laryngoplasty with voice monitoring

BACKGROUND: Laryngoplasty is an operation for voice reconstruction performed for recurrent laryngeal nerve palsy, and this operation needs intraoperative speech monitoring. Previously, all procedures were performed under local anesthesia. Therefore, patients were suffering, and otolaryngologists had difficulty because of patients' coughs and laryngeal movements. We used dexmedetomidine (DEX) with local anesthesia for laryngoplasty. METHODS: We retrospectively examined 6 patients who had undergone laryngoplasty from January 2008 to October 2010. Patients received local anesthesia for pain control and DEX for sedation. Anesthesiologists achieved adequate sedation level (Ramsay's score 3-4) with DEX. RESULTS: Sedation was induced with 6 microg x kg(-1). hr(-1) of DEX for 10 minutes. All patients were maintained at 0.2-1.2 microg x kg(-1) x hr(-1). A local anesthetic(8.6 +/- 2.3 ml of 1% lidocaine 1 : 100,000 epinephrine) was used. During the initial loading of DEX, the patients' vital signs were stable. DEX suppressed coughs and laryngeal movements and did not cause respiratory depression. They were able to respond to the otolaryngologists' demand for a voice test. CONCLUSIONS: Dexmedetomidine was useful for sedation during laryngoplasty with voice monitoring.