8 Bronchology – Past, Present and Future Diagnostic Procedures Operative Requirements and Basic Principles of Anesthesia for Bronchoscopy: • Good muscle relaxation. • Elimination of laryngospasms. • Facilitation of ventilation. Cough and gag reflexes should be suppressed during the intervention but must return rapidly after its completion. Pre-requisites for Anesthesia: • Adequate monitoring – ECG, BP, and pulse oximetry. • Anesthesia unit equipped with high O2 flow (20 L/min.) to compensate for air leaks around the bronchoscope. • Operating table with adjustable headrest. Complications during Anesthesia: • Damage of teeth. • Uncontrolled bleeding secondary to trauma. • Hypoventilation – hypoxia and hypercarbia. • Barotrauma. • Dysrhythmia. Anesthetic Techniques available in Bronchoscopy: • Local anesthesia. • General anesthesia – Balanced technique ( i.v. ). • General anesthesia – Inhalation technique. Advantages of Local Anesthesia: • Patient is awake. • Patient is cooperative. • Patient breathes spontaneously. Disadvantages of Local Anesthesia: • Only suitable for applications with a relatively short time limit. Extension of the time limit is difficult to achieve. • CO2 retention may occur. • Intraluminal bleeding is not well tolerated. • There is no guarantee that the patient will not suddenly move. General Anesthesia Techniques: • Intravenous balanced anesthesia technique. • Inhalation anesthesia technique. Back –––––––Table of Contents–––––––Next Back –––––––Table of Contents–––––––Next