ANAESTHESIA FOR BRONCHOSCOPY

Abstract

Bronchoscopy is an important tool in diagnosing and managi ng various pulmonary conditions. Diagnostic applications include; evaluation of a compromised airway, identification of the source of bleeding and others while therapeutic applications include; treatment of acute atelectasis and correcting malpositioned endotracheal or endobronchial tubes. Soon after the introduction of the flexible bronchoscope into clinical medicine, anaesthesiologists recognized its value in airway management. The flexible bronchoscope is used for airway management more than any other intubation technique or device, even though it was not developed for this purpose nor used for the first fiberoptic tracheal intubation. Now fiberscope is used in intubation in both awake and anaesthetized patients in case of difficult intubation by rigid laryngoscope. Also, it is considered one of the best methods for double lumen endobronchial intubation and to confirm its proper position. Fiberscope has an important role in ICU as it is used in changing endotracheal tubes and diagnosis of upper airway obstruction and in detection of complications that occur in prolonged endotracheal intubation. Also, it is used in diagnosis of the causative organisms of pneumonia via aspiration of a sample of pulmonary secretions. Generally, all the indications that apply for bronchoscopy in adults may be applied to the paediatric patients, but there are major differences between them. In adults, one is looking for signs of malignancy while in infants and children we are more concerned with congenital abnormalities, foreign bodies and other causes of airway obstruction.