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Anaesthesia for bronchoscopy.

Chadha M, Kulshrestha M, Biyani A - Indian J Anaesth (2015)

Bottom Line: Recently, conscious sedation has come up as the commonly used anaesthetic technique for simple bronchoscopic procedures.However, general anaesthesia still remains a standard technique for more complex procedures.New advances in the field of anaesthesiology such as use of short acting opioids, use of newer drugs such as dexmedetomidine, supraglottic airways and mechanical jet ventilators have facilitated and eased the conduct of the procedure.

View Article: PubMed Central - PubMed

Affiliation: Chief Anaesthetist, O.T. Superintendent and Pain Consultant, Vishesh Hospital, Indore, Madhya Pradesh, India.

ABSTRACT
Bronchoscopy as an investigation or therapeutic procedure demands anaesthesiologist to act accordingly. The present review will take the reader from rigid to fibreoptic flexible bronchoscopy. These procedures are now done as day care procedures in the operation theatre or in critical care units. Advantages and limitations of both rigid and flexible bronchoscopy are analysed. Recently, conscious sedation has come up as the commonly used anaesthetic technique for simple bronchoscopic procedures. However, general anaesthesia still remains a standard technique for more complex procedures. New advances in the field of anaesthesiology such as use of short acting opioids, use of newer drugs such as dexmedetomidine, supraglottic airways and mechanical jet ventilators have facilitated and eased the conduct of the procedure.

No MeSH data available.


Related in: MedlinePlus

Sanders jet ventilator
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Figure 2: Sanders jet ventilator

Mentions: The technique was originally described by Sanders[11] in 1967. There is a hand operated valve which is connected to 100% oxygen and the pressure is delivered at 50 pounds per square inch (psi) or less with respiratory rate between 10 and 14 breaths/min.[12] In children and infants the starting driving pressure should be approximately 0.5 psi adjusted according to chest expansion.[13] Respiratory rate and duration of breath is governed by chest inflation and oxygen saturation. The jet ventilation is applied by using a narrow bore cannula which is attached to the side of the bronchoscope,[12] or a long cannula along the long axis of the airway may be used with the tip going deep in the bronchoscope.[1415] The gas source is high pressure oxygen which is passed through the pressure reducing valves to produce the desired chest expansion and maintain necessary oxygenation[12] [Figure 2]. A jet frequency of 8–10/min is sufficient to allow time for exhalation and prevents air trapping and barotrauma. Standard monitoring is used during jet ventilation. Monitoring of tidal volume (VT) becomes difficult because the system is open and ambient air entrainment is unpredictable. Periodic CO2 and blood gas measurement or transcutaneous capnography may be used to assess ventilation.[16] Airway pressure can be monitored using a catheter placed in the distal trachea. Peak pressure should be below 35 cm of water.


Anaesthesia for bronchoscopy.

Chadha M, Kulshrestha M, Biyani A - Indian J Anaesth (2015)

Sanders jet ventilator
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4613403&req=5

Figure 2: Sanders jet ventilator
Mentions: The technique was originally described by Sanders[11] in 1967. There is a hand operated valve which is connected to 100% oxygen and the pressure is delivered at 50 pounds per square inch (psi) or less with respiratory rate between 10 and 14 breaths/min.[12] In children and infants the starting driving pressure should be approximately 0.5 psi adjusted according to chest expansion.[13] Respiratory rate and duration of breath is governed by chest inflation and oxygen saturation. The jet ventilation is applied by using a narrow bore cannula which is attached to the side of the bronchoscope,[12] or a long cannula along the long axis of the airway may be used with the tip going deep in the bronchoscope.[1415] The gas source is high pressure oxygen which is passed through the pressure reducing valves to produce the desired chest expansion and maintain necessary oxygenation[12] [Figure 2]. A jet frequency of 8–10/min is sufficient to allow time for exhalation and prevents air trapping and barotrauma. Standard monitoring is used during jet ventilation. Monitoring of tidal volume (VT) becomes difficult because the system is open and ambient air entrainment is unpredictable. Periodic CO2 and blood gas measurement or transcutaneous capnography may be used to assess ventilation.[16] Airway pressure can be monitored using a catheter placed in the distal trachea. Peak pressure should be below 35 cm of water.

Bottom Line: Recently, conscious sedation has come up as the commonly used anaesthetic technique for simple bronchoscopic procedures.However, general anaesthesia still remains a standard technique for more complex procedures.New advances in the field of anaesthesiology such as use of short acting opioids, use of newer drugs such as dexmedetomidine, supraglottic airways and mechanical jet ventilators have facilitated and eased the conduct of the procedure.

View Article: PubMed Central - PubMed

Affiliation: Chief Anaesthetist, O.T. Superintendent and Pain Consultant, Vishesh Hospital, Indore, Madhya Pradesh, India.

ABSTRACT
Bronchoscopy as an investigation or therapeutic procedure demands anaesthesiologist to act accordingly. The present review will take the reader from rigid to fibreoptic flexible bronchoscopy. These procedures are now done as day care procedures in the operation theatre or in critical care units. Advantages and limitations of both rigid and flexible bronchoscopy are analysed. Recently, conscious sedation has come up as the commonly used anaesthetic technique for simple bronchoscopic procedures. However, general anaesthesia still remains a standard technique for more complex procedures. New advances in the field of anaesthesiology such as use of short acting opioids, use of newer drugs such as dexmedetomidine, supraglottic airways and mechanical jet ventilators have facilitated and eased the conduct of the procedure.

No MeSH data available.


Related in: MedlinePlus