Anesthesia in interventional bronchoscopy

Abstract Interventional rigid bronchoscopy requires the same careful anesthetic management as any type of surgery. Furthermore, access to airways for both endoscopist and anaesthetist raises difficult problems. Hypoventilation with its consequences is a major risk, especially for patients with impaired ventilatory capacity. General anesthesia warrants controlled or assisted mechanical ventilation, without precise spirometric monitoring because of air leakage. Discussion of indications between both operators is needed. Careful preoperative evaluation is required. Ultra short intravenous anesthetic agents are chosen for a rapid recovery of consciousness and ventilation. Ventilation is generally manually assisted or delivered by high frequency jet ventilation. Flexible fiberoptic bronchoscopy is systematically performed before extubation. Interventional rigid bronchoscopy is ideally performed in an operating room or an adjacent area or in an intensive care unit in case of complication. Postoperative supervising in a recovery room is mandatory.