• Anaesthesia · Mar 2004

    Case Reports

    Local anaesthesia and sedation for rigid bronchoscopy for emergency relief of central airway obstruction.

    • I D Conacher and E Curran.
    • Department of Anaesthetics, Freeman Hospital, Freeman Road, Newcastle upon Tyne, NE7 7 DN, UK. i.d.conacher@btinternet.com
    • Anaesthesia. 2004 Mar 1; 59 (3): 290-2.

    AbstractWe report three experiences that illustrate the use of local anaesthesia for rigid bronchoscopy. All patients were acute emergencies, with life-threatening central airway problems. Instruments were inserted after the airway was anaesthetised using a technique that owes much to mid 20th Century methods for inserting endobronchial blockers. There is discussion about requirement to preserve and conserve self-ventilation and the securing of compromised central airways without the aid of neuromuscular blocking agents. Historical aspects of bronchoscopy are reviewed. Concomitant sedation reduced the unpleasantness of the experience in a way that in the past could only be dealt with by careful attention to the humanitarian elements of detail. Problems of oxygenation were ameliorated by periodically superimposing intermittent jetting with a Sanders injector fed from the oxygen pipeline. A need for developing and refining topical and other local anaesthetic techniques for rigid bronchoscopy is anticipated with the expansion of services for tracheo-bronchial stenting and lasering.

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