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Anesthesia for Bronchoscopy—An Update
Journal article   Open access   Peer reviewed

Anesthesia for Bronchoscopy—An Update

Basavana Goudra, Lalitha Sundararaman, Prarthna Chandar and Michael Green
Journal of clinical medicine, v 13(21), 6471
29 Oct 2024
url
https://doi.org/10.3390/jcm13216471View
Published, Version of Record (VoR) Open

Abstract

bronchoscopy remimazolam dexmedetomidine navigational bronchoscopy endobronchial valve thermoplasty
The field of interventional pulmonology has grown immensely and is increasingly recognized as a subspecialty. The new procedures introduced in the last decade pose unique challenges, and anesthesiologists need to readapt to their specific demands. In this review, we extensively discuss the pathophysiology, technical aspects, preprocedural preparation, anesthetic management, and postprocedural challenges of many new procedures such as navigational bronchoscopy, endobronchial valve deployment, and bronchial thermoplasty. Majority of these procedures are performed under general anesthesia with an endotracheal tube. Total intravenous anesthesia with rocuronium as a muscle relaxant seems to be the standard US practice. The easy availability and proven safety and efficacy of sugammadex as a reversal agent of rocuronium has decreased the need for high-dose remifentanil as an agent to avoid muscle relaxants. Additional research is available with regard to the utility of nebulized lidocaine and is discussed. Finally, two newer drugs administered for conscious sedation (typically without the need of an anesthesiologist) are likely to gain popularity in the future. Remimazolam is a new short-acting benzodiazepine with a relatively faster offset of clinical effects. Dexmedetomidine, a selective adrenergic agonist, is increasingly employed in bronchoscopy as a sedative during bronchoscopic procedures.

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Collaboration types
Domestic collaboration
Web of Science research areas
Respiratory System
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