CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by DUCKETT, J. E.
Right arrow Articles by PARR, G. V. S.
Right arrow Search for Related Content
PubMed
Right arrow Articles by DUCKETT, J. E.
Right arrow Articles by PARR, G. V. S.

Canadian Journal of Anesthesia, Vol 32, 67-72, Copyright © 1985 by Canadian Anesthesiologists' Society

General Anaesthesia for Nd:YAG Laser Resection of Obstructing Endobronchial Tumours using the Rigid Bronchoscope

JAMES E. DUCKETT MD1, THOMAS J. McDONNELL MD1, MICHAEL UNGER MD1, and GRANT V. S. PARR MD1

1 Departments of Anesthesia, Pulmonary Medicine and Cardio-Thoracic Surgery, Presbyterian-University of Pennsylvania Medical Center, Philadelphia, Pennsylvania

Address correspondence to: Dr. J.E. Duckett, Department of Anesthesia, Presbyterian-University of Pennsylvania Medical Center, 51 North 39th Street, Philadelphia, Pennsylvania 19104.

Provision of general anaesthesia for patients undergoing Nd:YAG laser resection of obstructing endobronchial tumours using the rigid bronchoscope presents unique problems for the anaesthesiologist. We studied 15 patients who underwent 20 of these procedures under general anaesthesia. Patients were anaesthetized and ventilated with either potent inhalation agents via the side arm of the ventilating bronchoscope (Group I: N = 8), or with intravenous agents and the Sanders jet injector attached to the rigid bronchoscope (Group II: N = 12). Patients were paralyzed and ventilation was controlled. The inspired gas mixture was nitrogen and oxygen, and the FiO2 was decreased to 0.3-0.4 during periods of resection. Group I patients had significantly higher peak pCO2's than Group II (8.3 kPa (62 mmHg) vs. 5.6 kPa (44 mmHg); lowest recorded pO2's were comparable and similar to pre-induction values. Both groups exhibited wide blood pressure fluctuations. Heart rates remained within 15 per cent of pre-induction levels. There were no intraoperative deaths, and no airway fires, massive haemorrhages or pneumothoraces. We conclude that these procedures can be undertaken with the use of general anaesthesia and the rigid bronchoscope, but that patients may encounter potentially serious respiratory or haemodynamic instability during the procedure.

Key Words: EQUIPMENT: laser, laser: Nd:YAG • SURGERY: bronchoscopy, bronchoscopy: rigid • VENTILATION: Venturi • MEASUREMENT TECHNIQUES: oximetry






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1985 by the Canadian Anesthesiologists' Society.