BY

Azza Lotfy
Ass. Lect. Of Anesthesia & ICU

LASER
Light Amplification of Stimulated Emission of Radiation

Physical principles of laser



Production of laser (Laser system hardware):

Physical principles of laser Characters of Laser beam :



Monochromatic: one wave length) Coherent: (oscillate in the same phase) Collimated: (exist as a narrow, parallel beam)

Effect of Laser on tissues:


  

Laser factors:
Wavelength Power density Duration


   

Tissue factors:
Absorption Thermal conductivity Local circulation Scatter

Types of medical Laser:

Laser media Color Wavelength (nm) Typical application Carbon dioxide Nd: YAG KTP:YAG Far infrared 10.600 Near infrared Green 1.064 532 General, cutting General, coagulation General, pigmented lesions Vascular, pigmented lesions Cornea, angioplasty

Argon

Green

514

Xenon fluoride

Ultraviolet

351

Advantage and clinical uses of laser:

   

Scalpel and electro coagulator. Allow precise microsurgery. Relatively dry field. Less postoperative edema and pain with lower infection rate.

Disadvantages of laser (hazard of laser)



  

Atmospheric contamination laser plume Misdirection of laser energy Gas embolism Energy transfer to an inappropriate location Fire and explosion

Disadvantages of laser (hazard of laser)

Atmospheric contamination laser plume:

1. 2. 3. 4. 5. Interstitial pneumonia. Bronchiolitis. Reduced mucociliary clearance, inflammation. Emphysema. Plume can be mutagenic, teratogenic or vector of viral infection.

Disadvantages of laser (hazard of laser)



Misdirection of laser energy: perforation of viscous or large blood vessels. Gas embolism: Venous gas embolism when laparoscopic or hysteroscopic laser surgery are reported. Energy transfer to an inappropriate location:
Eye damage (corneal opacities, retinal damage); Skin damage (from erythema to blisters or charring).

Fire and explosion: Laser contact with flammable material such as rubber or plastic may cause fire and explosion.

Airway Fire
 

1. 2. 3.

Incidence; 0.5% - 1.5% Predisposing factors; Flammable materials (ETT). Source of ignition (Laser beam). Gas support combustion (O2).

Airway Fire


Fire may be:



On external surface of ETT cause local thermal destruction. Blowtorch like fire.