Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) and Laser Laryngeal Surgery

Inclusion Criteria:

- Patients presenting for laser laryngeal surgery

Exclusion Criteria:

1. Patients with significantly decreased myocardial function (ejection fraction < 50%)

2. Patients with abnormal cardiac rhythm and conduction abnormalities, except for
patients with isolated, asymptomatic premature atrial and ventricular contractions.

3. Patients with significant peripheral vascular disease, such as those with the symptoms
of intermittent claudication.

4. Patients with known significant cerebrovascular disease, such as history of
cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAs) .

5. Patients with significant renal insufficiency, as manifested by estimated glomerular
filtration rate (eGFR) < 60 ml/min/1.73 m2.

6. Patients with electrolyte (K+, Ca++) abnormalities, as determined by the lab values
outside of a normal range.

7. Patients with the history or symptoms of increased intracranial pressure or reduced
intracranial compliance (e.g. headaches, nausea and vomiting, visual changes, mental
changes).

8. Patients with skull base defects.

9. Patients with pulmonary hypertension who have pulmonary artery pressures above the
normal range.

10. Patients with significant chronic obstructive or restrictive lung diseases, as
manifested by known history of baseline chronic hypoxia and/or hypercapnia, and/or
baseline room air oxygen saturation (SpO2) < 95% .

11. Obese patients with BMI > 35 kg/m2.

12. Patients with severe and poorly controlled gastroesophageal reflux disease despite
medical treatment.

13. Patients with hiatal hernia and full stomach patients.

14. Patient's refusal to participate in the study.

15. Patients who do not understand English or mentally handicapped. Pregnant or
breastfeeding patients.