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Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-1723
Sarkiss M. 1, Casal R. F. 2, Ost D. 2, Morice R. C. 2, Eapen G. A. 2, Jimenez C. A. 2
1 Department of Anesthesiology and Perioperative Medicine, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA;
2 Department of Pulmonary Medicine,University of Texas M. D. Anderson Cancer Center Houston, TX, USA
There is currently a growing interest in interventional bronchoscopy as it offers less invasive diagnostic and therapeutic options for patients with malignant and non-malignant airway disease. However, even in treatment centers with substantial experience in interventional bronchoscopy, complications for bronchoscopic interventions can have serious side effects and, rarely, result in death. Patients who undergo interventional bronchoscopy are frequently acutely ill, with numerous comorbidities, and at significant anesthetic risk, as evidenced by their high American Society of Anesethiologists (ASA) scores. Various anesthesia techniques have been described for the management of interventional bronchoscopy procedures. The range of anesthetic techniques which can be used for the same procedure varies widely from simple local anesthesia or conscious sedation performed by the bronchoscopist to monitored anesthesia care or general anesthesia performed by the anesthesiologist. Close collaboration between the anesthesiologist and interventional pulmonologist is important to the success of these procedures. Current guidelines do not provide exact indications as to which anesthesia technique to use for each procedure. The patient’s general medical condition, the amenities available to the bronchoscopist, as well as the type of bronchoscopic intervention usually dictate the anesthesia technique to be used. We will discuss in this review advantages of, and indications for, different anesthesia techniques used in various interventional bronchoscopy procedures.