Anesthesia for Bronchoscopy


Medication

Short acting or ultra-short acting anesthetics in order to avoid post procedure depression of respiratory function e.g., Propofol, Remifentanil

Anesthesia technique

TIVA in most cases. Inhalation anesthesia in patients with reactive airway

Ventilation

High FiO2 to maintain adequate saturation, expect and manage Hypercabnia, FiO2 reduction during LASER and cautery in the airway

Monitoring

Standard. BIS monitor for the depth of TIVA. Consider invasive or non-invasive hemodynamic monitoring for rigid bronchoscopy cases

Airway devices

LMA, rigid bronchoscope and less frequently ETT

Recovery

30–45 min with the use of ultra-short acting anesthetic medications





  • Frequent suctioning of airway secretion, blood and saline washes can alter the concentration of inhalation anesthetic dose delivered to the patient.


  • Frequent changes in airway devices used during a procedure, e.g., LMA, rigid bronchoscopy, endotracheal tube (ETT), can lead to interruption in the delivery of inhalation anesthetic and varying depth of anesthesia while the airway device is being exchanged.


  • Multiple insertion and removal of the bronchoscope through an airway device during a procedure can lead to leak of the inhalation agent to the environment of the bronchoscopy suite and exposure of the healthcare worker to anesthetic agents.


However, it is important to note that in the event of bronchospasm during bronchoscopic procedures, inhalation agents are considered a potent bronchodilator and the benefits of its use might outweigh the risks.

The authors preferred airway device for bronchoscopic procedures is the LMA and the rigid bronchoscopy.

Aug 26, 2017 | Posted by in Uncategorized | Comments Off on Anesthesia for Bronchoscopy

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