Laser Complications


Case Synopsis

A 75-year-old man with metastatic non–small cell carcinoma of the lung is scheduled for bronchoscopic tumor ablation using laser, under general anesthesia. He has a chronic nonproductive cough, and a computed tomography scan reveals tumor encroachment on the right bronchus.

Acknowledgment

The author wishes to thank Dr. Pattricia Klarr for her contribution to the previous edition of this chapter.

Problem Analysis

Definition

Improved technology, better reliability, and reduced cost have led to an increase in the applications for medical lasers over the past decade. Lasers deliver sterile, intense energy in the form of a beam of coherent monochromatic light by stimulated emission of photons from excited atoms. Patients and operating room (OR) personnel are exposed to certain hazards with medical lasers, including atmospheric contamination, inadvertent perforation of a tissue structure or vessel, ignition of flammable material, and embolism.

Although there are no federal safety requirements for medical lasers, there are national safety standards. The latter exist to decrease or prevent laser mishaps. Laser hazards are classified into four general risk categories, ranging from no risk to substantial risk. Medical lasers fall into the highest risk level. Therefore proper use requires trained personnel and protective equipment for the operation of medical lasers.

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