Abstract
The evolving field of interventional bronchoscopy has seen a parallel evolution of anesthesia techniques for various procedures. This chapter discusses a range of available types of anesthesia for patients undergoing interventional bronchoscopy procedures. Indications, advantages and disadvantages of topical anesthesia, conscious sedation, monitored anesthesia care, or general anesthesia are described in detail. The chapter also describes the setup of bronchoscopy suites as a replica of the operating room to perform various interventional bronchoscopic procedures. A review of new advances in the field of anesthesiology, such as the laryngeal mask airway, short-acting anesthetics with minimal effect on respiratory and cardiovascular functions, and mechanical jet ventilators, which are well suited for interventional bronchoscopic procedures is presented.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Bibliography
Becker HD. Bronchoscopy: the past, the present, and the future. Clin Chest Med. 2010;31(1):1–18.
Sarkiss M. Anesthesia for bronchoscopy and interventional pulmonology: from moderate sedation to jet ventilation. Curr Opin Pulm Med. 2011;17(4):274–8.
Gross JB, Bailey PL, Connis RT, et al. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Anesthesiology. 2002; 96(4):1004–17.
Ernst A, Silvestri GA, Johnstone D. Interventional pulmonary procedures: guidelines from the American College of Chest Physicians. Chest. 2003;123(5): 1693–717.
Bolliger CT, et al. ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J. 2002;19(2):356–73.
Bahhady IJ, Ernst A. Risks of and recommendations for flexible bronchoscopy in pregnancy: a review. Chest. 2004;126(6):1974–81.
Conacher ID, Curran E. Local anaesthesia and sedation for rigid bronchoscopy for emergency relief of central airway obstruction. Anaesthesia. 2004;59(3):290–2.
Perrin G, et al. Safety of interventional rigid bronchoscopy using intravenous anesthesia and spontaneous assisted ventilation. A prospective study. Chest. 1992;102(5):1526–30.
Ausseur A, Chalons N. [Anesthesia in interventional bronchoscopy]. Rev Mal Respir. 1999;16(4 Pt 2):679–83.
Ost DE, et al. Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration: results of the AQuIRE bronchoscopy registry. Chest. 2011;140(6):1557–66.
Herth FJ, et al. Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically and positron emission tomography-normal mediastinum in patients with lung cancer. Chest. 2008;133(4):887–91.
Sarkiss M, et al. Anesthesia technique for endobronchial ultrasound-guided fine needle aspiration of mediastinal lymph node. J Cardiothorac Vasc Anesth. 2007;21(6):892–6.
Honeybourne D, Babb J, Bowie P, et al. British Thoracic Society Bronchoscopy Guidelines Committee, a Subcommittee of the Standards of Care Committee of the British Thoracic Society Thorax. 2001; 56 (Suppl 1): i1–21.
Wahidi MM, et al. American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. Chest. 2011;140(5):1342–50.
Maguire GP, et al. Patients prefer sedation for fibreoptic bronchoscopy. Respirology. 1998;3(2):81–5.
Greig JH, et al. Sedation for fibreoptic bronchoscopy. Respir Med. 1995;89(1):53–6.
Fox BD, et al. Benzodiazepine and opioid sedation attenuate the sympathetic response to fiberoptic bronchoscopy. Prophylactic labetalol gave no additional benefit. Results of a randomized double-blind placebo-controlled study. Respir Med. 2008;102(7):978–83.
Abdelmalak B, et al. Dexmedetomidine as sole sedative for awake intubation in management of the critical airway. J Clin Anesth. 2007;19(5):370–3.
Clark G, et al. Titrated sedation with propofol or midazolam for flexible bronchoscopy: a randomised trial. Eur Respir J. 2009;34(6):1277–83.
Hohlrieder M, et al. Effect of total intravenous anaesthesia and balanced anaesthesia on the frequency of coughing during emergence from the anaesthesia. Br J Anaesth. 2007;99(4):587–91.
Ledowski T, et al. Bronchial mucus transport velocity in patients receiving propofol and remifentanil versus sevoflurane and remifentanil anesthesia. Anesth Analg. 2006;102(5):1427–30.
Ledowski T, et al. Neuroendocrine stress response and heart rate variability: a comparison of total intravenous versus balanced anesthesia. Anesth Analg. 2005;101(6):1700–5.
Purugganan RV. Intravenous anesthesia for thoracic procedures. Curr Opin Anaesthesiol. 2008;21(1):1–7.
Phillips W, et al. Propofol versus propofol/ketamine for brief painful procedures in the emergency department: clinical and bispectral index scale comparison. J Pain Palliat Care Pharmacother. 2008;24(4):349–55.
Ramsay MAE, Luterman DL. Dexmedetomidine as a total intravenous anesthetic agent. Anesthesiology. 2004;101(3):787–90.
Taittonen MT, et al. Effect of clonidine and dexmedetomidine premedication on perioperative oxygen consumption and haemodynamic state. Br J Anaesth. 1997;78(4):400–6.
Bruhn J, et al. Depth of anaesthesia monitoring: what’s available, what’s validated and what’s next? Br J Anaesth. 2006;97(1):85–94.
Vaitkeviciute I, Ehrenwerth J. Con: Bronchial stenting and laser airway surgery should not take place outside the operating room. J Cardiothorac Vasc Anesth. 2005;19:121–2.
Amat B, Reichle G, Agustà C, Xaubet A, Torres A. What is an interventional pulmonology unit in Europe? Clin Pulm Med. 2010;17(1):42–6.
Abdelmalak B, et al. Respiratory arrest after successful neodymium:yttrium-aluminum-garnet laser treatment of subglottic tracheal stenosis. Anesth Analg. 2002;95(2):485–6.
Hung WT, Liao SM, Su JM. Laryngeal mask airway in patients with tracheal stents who are undergoing non-airway related interventions: report of three cases. J Clin Anesth. 2004;16(3):214–6.
Kirsner KM, Sarkiss M, Brydges GJ. Treatment of tracheal and bronchial tumors and tracheal and bronchial stent placement. AANA J. 2010;78(5):413–9.
Ayers ML, Beamis Jr JF. Rigid bronchoscopy in the twenty-first century. Clin Chest Med. 2001;22(2): 355–64.
Wahidi MM, Herth FJ, Ernst A. State of the art: interventional pulmonology. Chest. 2007;131(1):261–74.
Clouzeau B, et al. Fiberoptic bronchoscopy under noninvasive ventilation and propofol target-controlled infusion in hypoxemic patients. Intensive Care Med. 2011;37(12):1969–75.
Ambrosino N, Guarracino F. Unusual applications of noninvasive ventilation. Eur Respir J. 2011;38(2): 440–9.
Fernandez-Bustamante A, et al. High-frequency jet ventilation in interventional bronchoscopy: factors with predictive value on high-frequency jet ventilation complications. J Clin Anesth. 2006;18(5): 349–56.
Kraincuk P, et al. A new prototype of an electronic jet-ventilator and its humidification system. Crit Care. 1999;3(4):101–10.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Sarkiss, M. (2013). Anesthesia for Interventional Bronchoscopic Procedures. In: DÃaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_4
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6009-1_4
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6008-4
Online ISBN: 978-1-4614-6009-1
eBook Packages: MedicineMedicine (R0)