Chapter 8 - Anesthetic implications of bronchoscopy

Summary

Rigid bronchoscopy (RB) was a necessary art of assessment of fitness for lung resection surgery and placing lung separator devices (LSD). For RB, general anesthesia is the norm. For short procedures a propofol and opioid supplemented induction is a usual regimen, followed by a short-acting non-depolarizing agent such as mivacurium. Manufacturers of positive pressure ventilation equipment pay little attention to the needs of patient ventilation during operation of their devices. Intrinsic and extrinsic lesions of the trachea can present as life-threatening emergencies. The erosion of a major vessel in the bronchial tree occasionally results in unstoppable hemoptysis. With much of the cardiac output coming up an RB, it is impossible to do anything to intervene. The advent of self-expanding devices has considerably eased the burden of sharing access to the airway with surgeons or physicians.