Abstract
Bronchoscopic procedures whether diagnostic or therapeutic constitute a challenge to both the brochoscopist and the patient due to the anxiety and vigorous airway reflexes associated with airway instrumentation as well as the pathology affecting airway patency and/or ventilation. This chapter will first describe the common bronchoscopic procedures and the main preoperative evaluation pointers. This is followed by a detailed description of the spectrum of anesthesia techniques, from light sedation to general anesthesia, that can be used to facilitate bronchoscopic procedures. Additionally, a depiction of a variety of ventilation techniques and airway devices that are used for airway procedures is detailed. Complications associated with bronchoscopic airway procedures and their management is also discussed. Lastly, the design of a bronchoscopic suite where anesthesia support for bronchoscopic procedures can be performed safely is described.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Becker HD. Bronchoscopy: the past, the present, and the future. Clin Chest Med. 2010;31(1):1–18, Table of Contents.
British Thoracic Society guidelines on diagnostic flexible bronchoscopy. Thorax. 2001;56(Suppl 1):i1–21.
Ost DE, Ernst A, Lei X, Feller-Kopman D, Eapen GA, Kovitz KL, Herth FJ, Simoff M. Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration: results of the AQuIRE Bronchoscopy Registry. Chest. 2011;140(6):1557–66.
Herth FJ, Eberhardt R, Krasnik M, Ernst A. 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, Kennedy M, Riedel B, Norman P, Morice R, Jimenez C, Eapen G. Anesthesia technique for endobronchial ultrasound-guided fine needle aspiration of mediastinal lymph node. J Cardiothorac Vasc Anesth. 2007;21(6):892–6.
Khan KA, Nardelli P, Jaeger A, O’Shea C, Cantillon-Murphy P, Kennedy MP. Navigational bronchoscopy for early lung cancer: a road to therapy. Adv Ther. 2016;33(4):580–96.
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, Colt HG, Martin C, Mak MA, Dumon JF, Gouin F. Safety of interventional rigid bronchoscopy using intravenous anesthesia and spontaneous assisted ventilation. A prospective study. Chest. 1992;102(5):1526–30.
Ernst A, Silvestri GA, Johnstone D. Interventional pulmonary procedures: guidelines from the American College of Chest Physicians. Chest. 2003;123(5):1693–717.
Ausseur A, Chalons N. [Anesthesia in interventional bronchoscopy]. Rev Mal Respir. 1999;16(4 Pt 2):679–83.
Wahidi MM, Jain P, Jantz M, Lee P, Mackensen GB, Barbour SY, Lamb C, Silvestri GA. 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.
Fox BD, Krylov Y, Leon P, Ben-Zvi I, Peled N, Shitrit D, Kramer MR. 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, Makary L, Hoban J, Doyle DJ. Dexmedetomidine as sole sedative for awake intubation in management of the critical airway. J Clin Anesth. 2007;19(5):370–3.
Clark G, Licker M, Younossian AB, Soccal PM, Frey JG, Rochat T, Diaper J, Bridevaux PO, Tschopp JM. Titrated sedation with propofol or midazolam for flexible bronchoscopy: a randomised trial. Eur Respir J. 2009;34(6):1277–83.
Bruhn J, Myles PS, Sneyd R, Struys MM. Depth of anaesthesia monitoring: what’s available, what’s validated and what’s next? Br J Anaesth. 2006;97(1):85–94.
Abdelmalak B, Ryckman JV, AlHaddad S, Sprung J. Respiratory arrest after successful neodymium:yttrium-aluminum-garnet laser treatment of subglottic tracheal stenosis. Anesth Analg. 2002;95(2):485–6, table of contents.
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 JF Jr. 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, Bui HN, Guilhon E, Grenouillet-Delacre M, Leger MS, Saghi T, Pillot J, Filloux B, Coz S, Boyer A, et al. Fiberoptic bronchoscopy under noninvasive ventilation and propofol target-controlled infusion in hypoxemic patients. Intensive Care Med. 2011;37:1969–75.
Ambrosino N, Guarracino F. Unusual applications of noninvasive ventilation. European Respiratory Journal. 2011;38(2):440–9.
Fernandez-Bustamante A, Ibanez V, Alfaro JJ, de Miguel E, German MJ, Mayo A, Jimeno A, Perez-Cerda F, Escribano PM. 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, Kepka A, Ihra G, Schabernig C, Aloy A. A new prototype of an electronic jet-ventilator and its humidification system. Crit Care. 1999;3(4):101–10.
Vaitkeviciute IEJ. 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, Günther R, Carlos A, Antoni X, Antoni T. What is an interventional pulmonology unit in Europe? Clinical Pulmonary Medicine. 2010;17(1):42–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Sarkiss, M. (2018). Anesthesia for Bronchoscopic Procedures. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_21
Download citation
DOI: https://doi.org/10.1007/978-3-319-74766-8_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74765-1
Online ISBN: 978-3-319-74766-8
eBook Packages: MedicineMedicine (R0)