Abstract
References
- de Lima A, Kheir F, Majid A, Pawlowski J. Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy. Can J Anaesth 2018; 65: 822-36.
- Okiror L, Jiang L, Oswald N, et al. Bronchoscopic management of patients with symptomatic airway stenosis and prognostic factors for survival. Ann Thorac Surg 2015; 99: 1725-30.
- Bakan M, Topuz U, Umutoglu T, et al. Remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy: comparison of adjuvant propofol and ketamine. Clinics (Sao Paulo) 2014; 69: 372-7.
- Kanonidou Z, Karystianou G. Anesthesia for the elderly. Hippokratia 2007; 4: 175-7.
- Cavalieri TA. Managing pain in geriatric patients. J Osteopathic Med 2007; 107: E10-E16.
- Gloth FM 3rd. Pain management in older adults: prevention and treatment. J Am Geriatr Soc 2001; 49: 188-99.
- Cavalieri TA. Pain management in the elderly. J Am Osteopath Assoc 2002; 102: 481-5.
- Arias S, Lee HJ. The future of interventional pulmonology. Semin Respir Crit Care Med 2014; 35: 6.
- Dincq AS, Gourdin M, Collard E, et al. Anesthesia for adult rigid bronchoscopy. Acta Anaesthesiol Belg 2014; 65: 95-103.
- Chadha M, Kulshrestha M, Biyani A. Anaesthesia for bronchoscopy. Indian J Anaesth 2015; 59: 565-73.
- Putz L, Mayné A, Dincq AS. Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review. Biomed Res Int. 2016; 2016: 4234861.
- Ramaswamy AH, Kurdi MS, Shaikh SI, Deva RS, Raza SU. Awake rigid bronchoscopy for post intubation tracheal stenosis. Anaesth Pain & Intensive Care 2014; 18: 299-301.
- Bolliger CT, Mathur PN, Beamis JF, et al. ERS/ATS statement on interventionalpulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J 2002; 19: 356-73.
- Salman Önemli C, Çatal DA. Trakeal Stenozun Rijit Bronkoskop ve Balon Dilatasyonla Tedavisinde Total İntravenöz Anestezi Kullanımı: Dört Olgunun Sunumu. GKDA Derg 2015; 21, 4: 174-9.
- Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med 2008; 358: 1097-108.
- Zorrilla-Vaca A, Healy RJ, Wu CL, Grant MC. Relation between bispectral index measurements of anesthetic depth and postoperative mortality: a meta-analysis of observational studies. Can J Anaesth 2017; 64: 597-607.
- Arıkan M, Ulus F, Sazak H, Şavkıoğlu E, Pehlivanoğlu P, Cengiz Z. Yaşlılığın rokuronyum ile sağlanan nöromüsküler bloğa etkisinin train of four (TOF) ve posttetanik count (PTC) ile değerlendirilmesi. Ortadoğu Tıp Dergisi 2011; 3: 61-5.
- Honing G, Martini CH, Bom A, et al. Safety of sugammadex for reversal of neuromuscular block. Expert Opin Drug Saf 2019; 18: 883-91.
- Brueckmann B, Sasaki N, Grobara P, et al. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study. Br J Anaesth 2015; 115: 743-51.
Anesthesia management in geriatric patients which were interventional bronchoscopy due to central airway obstruction; retrospective analysis
Abstract
Aim: In the endobronchial treatment of tumors that cause obstruction in the tracheobronchial system; Applications such as cryo-recanalization and argon plasma coagulation (APC) are widely used. Patients presenting with central airway obstruction (CAO) require urgent intervention, sharing the airway with the bronchoscopist, severe shortness of breath in patients, and the presence of comorbid diseases make it difficult for anesthetists. This situation becomes more complicated due to pharmacokinetic and pharmacodynamic changes in geriatric patients. In this article, it is aimed to present the anesthesia method in geriatric patients who underwent interventional bronchoscopy due to central airway obstruction.
Material and Method: The files of geriatric patients who underwent interventional procedures for central airway obstruction between January 2021 and September 2021 were reviewed retrospectively. The treatments applied to the patients and the applied anesthetic protocols were recorded.
Results: Forty-five geriatric patients who underwent interventional procedures for CAO were identified. 74% of the patients were male. 95.6% of the patients were in the American Society of Anesthesiologists (ASA) III or ASA IV risk group, which we can refer to as the high risk group. It was observed that rapid and short-acting propofol and remifentanil were used in induction and maintenance of anesthesia, rocuronium was used as muscle relaxant, and sugammadex was used to eliminate the residual effect of the muscle relaxant.
Conclusion: Airway management is very complex in severe life-threatening airway stenosis. This situation requires a more comprehensive preoperative evaluation, selection of appropriate short-acting anesthetics, and effective anesthetic monitoring, especially in geriatric patients. In addition, the anesthetist and bronchoscopist should be prepared and in constant communication against complications that may develop.
References
- de Lima A, Kheir F, Majid A, Pawlowski J. Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy. Can J Anaesth 2018; 65: 822-36.
- Okiror L, Jiang L, Oswald N, et al. Bronchoscopic management of patients with symptomatic airway stenosis and prognostic factors for survival. Ann Thorac Surg 2015; 99: 1725-30.
- Bakan M, Topuz U, Umutoglu T, et al. Remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy: comparison of adjuvant propofol and ketamine. Clinics (Sao Paulo) 2014; 69: 372-7.
- Kanonidou Z, Karystianou G. Anesthesia for the elderly. Hippokratia 2007; 4: 175-7.
- Cavalieri TA. Managing pain in geriatric patients. J Osteopathic Med 2007; 107: E10-E16.
- Gloth FM 3rd. Pain management in older adults: prevention and treatment. J Am Geriatr Soc 2001; 49: 188-99.
- Cavalieri TA. Pain management in the elderly. J Am Osteopath Assoc 2002; 102: 481-5.
- Arias S, Lee HJ. The future of interventional pulmonology. Semin Respir Crit Care Med 2014; 35: 6.
- Dincq AS, Gourdin M, Collard E, et al. Anesthesia for adult rigid bronchoscopy. Acta Anaesthesiol Belg 2014; 65: 95-103.
- Chadha M, Kulshrestha M, Biyani A. Anaesthesia for bronchoscopy. Indian J Anaesth 2015; 59: 565-73.
- Putz L, Mayné A, Dincq AS. Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review. Biomed Res Int. 2016; 2016: 4234861.
- Ramaswamy AH, Kurdi MS, Shaikh SI, Deva RS, Raza SU. Awake rigid bronchoscopy for post intubation tracheal stenosis. Anaesth Pain & Intensive Care 2014; 18: 299-301.
- Bolliger CT, Mathur PN, Beamis JF, et al. ERS/ATS statement on interventionalpulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J 2002; 19: 356-73.
- Salman Önemli C, Çatal DA. Trakeal Stenozun Rijit Bronkoskop ve Balon Dilatasyonla Tedavisinde Total İntravenöz Anestezi Kullanımı: Dört Olgunun Sunumu. GKDA Derg 2015; 21, 4: 174-9.
- Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med 2008; 358: 1097-108.
- Zorrilla-Vaca A, Healy RJ, Wu CL, Grant MC. Relation between bispectral index measurements of anesthetic depth and postoperative mortality: a meta-analysis of observational studies. Can J Anaesth 2017; 64: 597-607.
- Arıkan M, Ulus F, Sazak H, Şavkıoğlu E, Pehlivanoğlu P, Cengiz Z. Yaşlılığın rokuronyum ile sağlanan nöromüsküler bloğa etkisinin train of four (TOF) ve posttetanik count (PTC) ile değerlendirilmesi. Ortadoğu Tıp Dergisi 2011; 3: 61-5.
- Honing G, Martini CH, Bom A, et al. Safety of sugammadex for reversal of neuromuscular block. Expert Opin Drug Saf 2019; 18: 883-91.
- Brueckmann B, Sasaki N, Grobara P, et al. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study. Br J Anaesth 2015; 115: 743-51.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | January 21, 2022 |
| Publication Date | January 24, 2022 |
| Published in Issue | Year 2022 Volume: 4 Issue: 1 |
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