STRIVE Hi approach to endoscopic airway surgery 2

SponTaneous Respiration using IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) is a recently developed, spontaneous ventilation open airway technique, which facilitates microlaryngoscopy and endoscopic airway surgery in adults. The STRIVE Hi utilizes an upwardly titrated target-controlled infusion (TCI) of propofol, frequently with the addition of remifentanil, in combination with high-flow nasal oxygen (HFNO) delivery at 70 l/min.

The presented videos demonstrate good operating conditions and absent airway reactivity to surgical manipulation. In most cases, the vocal cords were abducted and immobile or associated with minimal movement, which did not interfere with the surgical procedure. Video 1 shows a severe lambdoid tracheal stenosis with abducted immobile vocal cords, and Video 2 shows a ball-valve laryngeal cancer with abducted and minimally moving vocal cords.

Please read a full report by Drs. Booth and Vidhani in SHANA’s Journal of Head and Neck Anesthesia.