Anesthesia for Advanced Bronchoscopic Procedures: State-of-the-Art Review

Basavana G. Goudra, Preet Mohinder Singh, Anuradha Borle, Nahla Farid, Kassem Harris

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations

Abstract

The bronchoscopic procedures have seen a remarkable increase in both numbers and complexity. Although many anesthesia providers have kept pace with the challenge, the practice is varied and frequently suboptimal. Shared airway during bronchoscopy poses unique challenges. The available reviews have tried to address this lacuna; however, these have frequently dealt with the technical aspects of bronchoscopy than anesthetic challenges. The present review provides evidence-based management insights into anesthesia for bronchoscopy—both flexible and rigid. A systematic approach toward pre-procedural evaluation and risk stratification is presented. The possible anatomical and physiological factors that can influence the outcomes are discussed. Pharmacological principles guiding sedation levels and appropriate selection of sedatives form the crux of safe anesthetic management. The newer and safer drugs that can have potential role in anesthesia for bronchoscopy in the near future are discussed. Ventilatory strategies during bronchoscopy for prevention of hypoxia and hypercarbia are emphasized.

Original languageEnglish
Pages (from-to)453-465
Number of pages13
JournalLung
Volume193
Issue number4
DOIs
StatePublished - Aug 23 2015

Keywords

  • Anesthesia for bronchoscopy
  • Sedation for bronchoscopy
  • Sedation for interventional pulmonology
  • Sedatives for bronchoscopy
  • Ventilation during bronchoscopy

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