Anesthesia for bronchoscopy

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Anesthesia for bronchoscopy
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• 90 year old male
• HTN history
• METgt4
• Miss swallow metallic denture to right lower lobe
  bronchus
• Right lower lobe pneumonia

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(No Transcript)
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Intraoperative management
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Pre-OP evaluation

• PE, breathing sound, SOB?
• Why the procedure will be done?
• Foreign body
• Biopsy
• Stent
• GA medication preparation
• Fentanyl
• Propofol Etomidate
• Cisa, Esmeron, SCC

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• General anesthesia
• Rigid bronchoscope insertion
• Video assist? scope inserted to trachea was
  visible
• Without video? follow the action by the surgeon
• Remove endotracheal tube
• Re-prepare the intubation tool
• Scope, endo, suction
• Change the tubing to the side hole of rigid
  bronchoscope

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• Change the mode of ventilator
• Without capnography
• Jet ventilate
• flow?, FiO2?(if no laser therapy was needed)
• Watch out the SpO2
• If duration of the procedure was long? F/U the
  gas (PaCO2)
• Air leakage
• Inhalation?
• Or shit to total iv-general anasthesia
• Akinesia
• Adequate muscle relaxant

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• Extubation
• Laryngoedema due to the repeat procedure
• Steroid usage
• Delayed extubation
• Post-procedure trauma
• Bleeding
• Even post-OP ICU engaged

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Thanks for your attention