Anesthesia for Bronchoscopic Laser Surgery

Choice of anesthesia for bronchoscopic laser surgery depends on the surgical technique. Fiberoptic bronchoscopy can be managed with either topical or general anesthesia, while rigid bronchoscopy usually requires general anesthesia. In either case precautions for laser surgery must be taken. Preoperative evaluations should include cardiovascular status and the anatomy of the lesion. Preoperative medication should include an anticholinergic agent. The influence of total intravenous vs. inhaled anesthetics on prolonged respiratory depression is discussed, and the techniques for providing controlled vs. spontaneous respiration are described. Finally, postoperative care, including the management of airway obstruction and hemorrhage, is outlined.