Diagnostic Bronchoscopy - Basic Techniques

Persistent Notes

In particular, bronchoscopy performed for the evaluation of hemoptysis or wheezing should also include a careful evaluation of the upper airway, including the nasopharynx, oropharynx, and vocal cords.
The nasal route is avoided in patients suspected to have foreign body aspiration, to have sufficient room to remove the object, and among those with coagulopathies, because of the risk of epistaxis.
The combination of hydrocodone and midazolam reduces cough during FB without causing significant desaturation and improves the patient’s tolerance for the procedure.
However, it has been shown that dexmedetomidine as a sole agent is unable to provide adequate sedation
propofol alone has been shown to be as effective and safe as combined sedation
combination of propofol and hydrocodone was safe and better for cough suppression than propofol alone
human immunodeficiency virus infection, recipients of stem cell transplantation, lung transplant recipients for cystic fibrosis, and drug users.
- needs higher doses of sedatives
nasal anesthesia.
1% is preferred because larger volumes can be instilled to cover a greater surface area of the mucosa
oropharynx can be anesthetized with 2–4% lidocaine
The total dose of lidocaine should be limited to 8.2 mg/kg in adults, with extra caution in the elderly or those with liver, renal, or cardiac impairments.