Painless Bronchoscopy Research Articles

Research Progress of Bronchoscopy Clinical Anesthesia

Bronchoscopy is an invasive examination method, and the anesthesia method of early examination is mainly local anesthesia. However, due to the long operation time of more diagnosis and treatment items, large damage stimulation to patients, and high risk factors, simple local anesthesia can no longer meet the demand. With the popularization of the concept of comfortable medical treatment, the demand for painless bronchoscopy technology is increasing. In the process of examination, the basic situation of patients, economic burden and the shortage of anesthesiologists in the country should be comprehensively considered, and individualized anesthesia plans should be formulated for patients. Select appropriate anesthesia methods such as local anesthesia, sedative anesthesia and general anesthesia to provide clinical reference for reducing patients' anxiety in the process of bronchoscopy operation and improving patient tolerance and comfort.

Effect of Different Insertion Methods on LMA Protector-Related Complications: A Prospective Randomized Double-Blind Clinical Trail.

The authors compared the effect of 2 insertion methods, namely the conventional laryngeal mask airway (LMA) insertion and the index finger-assisted LMA insertion, on the incidence of complications associated with LMA Protector insertion. The authors enrolled 300 patients, who underwent painless bronchoscopy. The patients ranged in age between 18 and 75 and were classified as American Society of Anesthesiologists grade I to III. They were randomly divided into 2 groups: a control group of 150 patients and an assisted group comprising 150 patients. LMA was inserted using the conventional and index finger-assisted insertion methods in both groups, respectively. The primary outcome was postoperative complications, such as oral mucosal injury and pharyngeal pain. Secondary outcomes included the success rate of first-time insertion, the incidence rate of inverse folding of LMA tips, oropharyngeal leak pressure (OLP), and other postoperative complications. Compared with the conventional LMA insertion method, index finger-assisted LMA insertion can significantly reduce the incidence rate of oral mucosal injury and pharyngeal pain, with fewer insertion failures. There was a statistically significant difference between the 2 groups in the visual field grading before adjustment for LMA alignment (P<0.0001). The conventional insertion method increased the likelihood of inverse folding of LMA tips. When the conventional insertion method was utilized, there was a significant difference in airway pressure and tidal volume before and after alignment under a fiberoptic bronchoscope (P<0.0001), but no significant difference in visual field grading and respiratory mechanics-related indicators. Index finger-assisted insertion can significantly reduce the incidence rate of LMA Protector-related complications and inverse folding of LMA tips.

To establish a risk prediction model for the occurrence of hypoxemia during painless bronchoscopy.

The present study was focused on evaluating the clinical predictors of hypoxemia and establishing a multivariable, predictive model for hypoxemia in painless bronchoscopy. A total of 244 patients were enrolled in the study, and data were collected using a self-designed data collection. The retrospective data collected in this study included the relevant data of patients undergoing the painless bronchoscopy, and we used univariate analysis to deal with these influencing factors. Multivariate logistic regression analysis was used to establish the prediction equation, and receiver operating characteristic curve analysis was carried out. Receiver operating characteristic curves and the Hosmer-Lemeshow test were used to evaluate the model performance. P < .05 was considered to indicate statistical significance. Multivariate logistic regression indicated that body mass index (BMI) (odds ratio [OR]: 1.169; 95% confidence interval [CI]: 1.070-1.277), arterial partial pressure of oxygen (PaO2) (OR: 4.279; 95% CI: 2.378-7.699), alcohol consumption (OR: 2.021; 95% CI: 1.063-3.840), and whether the bronchoscope operation time exceeds 30 minutes (OR: 2.486; 95% CI: 1.174-5.267) were closely related to the occurrence of hypoxemia. The prediction model developed by the logistic regression equation was -4.911 + 1.454 (PaO2) + 0.156 (BMI) + 0.703 (Alcohol consumption) + 0.911 (time > 30th minutes). The prediction model showed that the area under the receiver operating characteristic curve was 0.687. The predictive model was well calibrated with a Hosmer-Lemeshow x2 statistic of 4.869 (P = .772), indicating that our prediction model fit well. The accuracy (number of correct predictions divided by the number of total predictions) was 75%. The prediction model, consisting of BMI, PaO2, alcohol consumption, and whether the bronchoscope operation time exceeds 30 minutes. It is an effective predictor of hypoxemia during sedation for painless bronchoscopy.

He application value of laryngeal mask airway general anesthesia in painless bronchoscopy and its influence on the sense of comfort and satisfaction

This study explores the applicability of general anesthesia with a laryngeal mask airway in painless bronchoscopy and its impact on the sense of comfort and satisfaction. Using the random number table method, we divided 101 elderly patients with respiratory disease who underwent bronchoscopy into two groups, with one group receiving intravenous general anesthesia (IVGA) and the other group receiving laryngeal mask airway general anesthesia (LMAGA). Their vital signs, including heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2), were compared and we also examined their perioperative adverse effects and assessed the sense of comfort and satisfaction. There were no significant differences in vital signs, including HR, MAP and SpO2, between the two groups before anesthesia (T0). However, at T1 and T2, the HR of patients in the LMAGA group was significantly lower than that of the IVGA group. Additionally, the MAP and SpO2 levels in the LMAGA group were significantly higher than those in the IVGA group. The LMAGA group also demonstrated significantly shorter surgical duration and faster recovery from anesthesia than the IVGA group. Furthermore, the LMAGA group exhibited a significantly lower incidence of adverse effects and a notable increase in comfort and satisfaction compared to the IVGA group. LMAGA demonstrates a significant anesthetic effect in painless bronchoscopy, effectively improving the patient’s vital signs, reducing the duration of the operation and anesthetic recovery time, lowering the occurrence of perioperative adverse reactions, and enhancing the overall sense of comfort and satisfaction.

Gender differences in the effective dose of alfentanil in painless bronchoscopy.

Gender differences in the effective dose of alfentanil in painless bronchoscopy.

Clinical effects of remimazolam alone or in combination with dexmedetomidine in patients receiving bronchoscopy and influences on postoperative cognitive function: a randomized-controlled trial.

Remimazolam and dexmedetomidine are commonly used as sedatives. However, the effects and safety of remimazolam alone or in combination with dexmedetomidine have not been investigated. We sought to investigate the clinical effects of remimazolam alone or in combination with dexmedetomidine in bronchoscopy, and their influence on cognitive function. Ninety eligible patients who underwent bronchoscopy under intravenous anesthesia were randomly divided into three groups: propofol control, remimazolam, and remimazolam plus dexmedetomidine. The primary outcome was the incidence of perioperative hypoxemia. Secondary outcomes included induction and maintenance doses of remimazolam, hemodynamic variables, scores for modified Observer's Assessment of Alertness/Sedation (MOAA/S), coughing, limb movement, incidence of adverse events, patient satisfaction, bronchoscopist satisfaction, incidence of post-operative cognitive dysfunction (POCD), time to loss of consciousness (LoC), and time to awake. The incidence of hypoxemia, hypotension, and bronchoscopist satisfaction score were significantly decreased, and time to LoC and time to awake were markedly longer in the remimazolam and remimazolam plus dexmedetomidine groups than in the propofol control group (p < 0.05). The remimazolam group had significantly decreased induction and maintenance doses of remimazolam and a shorter time to LoC than the remimazolam plus dexmedetomidine group (p < 0.05). Scores for coughing, limb movement, MOAA/S, and post-operative patient satisfaction were comparable among the three groups. POCD was not induced in any of the groups. Remimazolam is safe and effective for painless bronchoscopy, with a low incidence of adverse reactions, and exhibits a good synergistic effect with dexmedetomidine. This trial protocol had been registered on Chinese Clinical Trial Registry (ChiCTR2000041435, date: 2020 12 26.

The effect of intravenous lidocaine on propofol dosage in painless bronchoscopy of patients with COPD.

BackgroundWe tested the hypothesis that intravenous (IV) lidocaine reduces propofol requirements in painless bronchoscopy in patients with chronic obstructive pulmonary disease (COPD).MethodsA total of 93 patients who underwent bronchoscopy were included in this randomized placebo-controlled study. The patients were randomly divided into two groups. After the IV doses of nalbuphine, patients were given a bolus of propofol, which was titrated if necessary until loss of consciousness. Then patients were given IV lidocaine (2 mg/kg then 4 mg/kg/h) or the same volume of saline. The primary endpoint was the propofol requirements. Secondary endpoints were the incidence of hypoxemia, the incidence of cough during glottis examination, the systolic blood pressure (SBP) and heart rate (HR) during bronchoscopy procedures, the bronchoscopist's comforts, and the time for wakefulness before recovery.ResultsLidocaine infusion resulted in a significant reduction in propofol requirements (p < .0001), and the incidence of hypoxemia (p = .001) and cough (p = .003) during examination decreased significantly in the lidocaine group. During the examination, the fluctuation of SBP and HR was significantly lower than that in the control group, and the difference was statistically significant (p < .05). Bronchoscopist's comforts were higher in the lidocaine group (p < .001), and time for wakefulness (p < .001) were significantly lower in the lidocaine group.ConclusionIn painless bronchoscopy in patients with COPD, IV infusion of lidocaine resulted in a reduction in propofol dose requirements and reduce the incidence of adverse events.

Estimation of the median effective dose and the 95% effective dose of alfentanil required to inhibit the bronchoscopy reaction during painless bronchoscopy with i-gel supraglottic airway device: an Up-and-Down Sequential Allocation Trial.

BackgroundIn practice, the optimal dose of alfentanil that should be used when painless bronchoscopy is performed is unknown. The purpose of this study was to investigate the effective dose of alfentanil in suppressing bronchoscopy responses to painless bronchoscopy with an i-gel supraglottic airway device.MethodsPatients aged 18–70 years, with American Society of Anesthesiologists (ASA) physical status I–II, who planned to undergo painless bronchoscopy were recruited for this study. Alfentanil was administered intravenously 2 minutes before propofol administration. The response to bronchoscopy was measured, including oxygen saturation (SPO2) and changes in respiratory rhythm. The median effective dose of alfentanil (ED50) required to alleviate responses to the bronchoscopy was calculated using Dixon’s up-and-down method in the female and male groups. Probit analysis was used to generate a dose-response curve in each group.ResultsA total of 48 patients were recruited for the study including 25 females and 23 males. The ED50 of alfentanil for suppressing responses to painless bronchoscopy in females and males was 13.68±4.75 and 17.96±3.45 µg/kg, respectively. The difference was not statistically significant between the two groups (P=0.078). Probit analysis showed the ED50 of alfentanil in female bronchoscopy was 12.4 µg/kg [95% confidence interval (CI): 4.5 to 17 µg/kg]. In men, the ED50 of alfentanil was 16.4 µg/kg (95% CI: 12.1 to 20.1 µg/kg). According to the probit analysis, the 95% effective dose (ED95) of alfentanil was 22.4 µg/kg (95% CI: 17.5 to 67.3 µg/kg) in female bronchoscopy. In men, the ED95 of alfentanil was 23.3 µg/kg (95% CI: 19.8 to 46.2 µg/kg).ConclusionsOur data suggest that there were no obvious differences between men and women in the effective dose of alfentanil in painless bronchoscopy.

Analysis of diagnostic characteristics and clinical related factors of 70 patients with atelectasis by painless bronchoscopy.

Objectives:To analyze the diagnostic characteristics and clinical related factors of patients with atelectasis by painless electronic bronchoscopy.Methods:A retrospective analysis was performed on 70 patients with atelectasis admitted to Xuancheng People’s Hospital from April 2019 to June 2021. The clinical data of the patients and the diagnosis characteristics under painless electronic bronchoscope were analyzed, and the clinical related factors were investigated.Results:Seventy patients with atelectasis underwent pathological examination and bacteriological examination after painless electronic bronchoscopy, including 16 cases (22.86%) of inflammation, 11 cases (15.71%) of tuberculosis, 36 cases (51.43%) of tumor, one case (1.43%) of inflammatory polyp, one case (1.43%) of congenital dysplasia, two cases (2.86%) of foreign body inhalation, and three cases (4.29%) of other symptoms. Male patients with atelectasis showed most cauliflower-like tumors and mucosal swelling under electronic bronchoscopy (P<0.05), while female patients showed scar occlusion/stenosis at most (P<0.05). Middle-aged and elderly patients under electronic bronchoscopy showed most cauliflower-like tumors, scar stenosis/occlusion and mucosal swelling cavity, while young patients mainly showed necrosis and purulent secretions. Heavy smokers were most likely to have cauliflower-like tumors, while non-smokers were predominantly with scar stenosis/occlusion.Conclusions:Painless electronic bronchoscopy is of great value in the clinical diagnosis of patients with atelectasis, and it is likely to further clarify the etiology of atelectasis. Age, sex, and quantity of smoking may be clinical factors associated with atelectasis.

Sealing-type Three-cavities Ventilation Joint: A New Device in Painless Bronchoscopy

Background: To observe the clinical effect and safety of the sealing-type three-cavities ventilation joint in painless bronchoscopy. To compare the respiratory mechanics between I-gel laryngeal mask and tracheal tube-controlled breath during bronchoscopy. Methods: 200 patients underwent bronchoscopy were recruited and randomly assigned to general anesthesia group (group Ⅰ, n = 100) and local anesthesia group (group Ⅱ, n = 100). General anesthesia group were divided into two groups, the I-gel laryngeal mask combined with sealing-type three-cavities ventilation joint group group(n=50) and the endotracheal tube combined with sealing-type three-cavities ventilation joint group(n=50). Patients in Group I were adopted by I-gel laryngeal mask or endotracheal tube with the sealing-type three-cavities ventilation joint after the induction anesthesia with remifentanil, propofol and succinylcholine. In group II, patients were anaesthetized with lidocaine and followed by 2mg/ kg propofol iv, and spontaneous respirations were retained with nasal cannula. All patients’ vital signs, endoscopic related adverse reactions and arterial blood gas analysis were recorded during the procedure. Results: Group I showed little changes of vital signs (P &lt;0.05), and less adverse reaction such as the intraoperative hypoxia and intraoperative body movement (P &lt;0.05), and no significant decrease of oxygen partial pressure (P &lt;0.05). There is no significant difference in respiratory mechanics including tidal volume and airway pressure between two subgroups in group I(P&gt;0.05). Conclusion: Sealing-type three-cavities ventilation joint prevents the oxygen deficit and makes it possible for us to examine patients through bronchoscope under general anesthesia without gas leakage. Moreover, sealing-type three-cavities ventilation joint provides safe and effective airway control while it does not change respiratory mechanics in endotracheal tube group compared with I-gel laryngeal mask makes endotracheal tube an alternative solution in bronchoscope. Take all these in consideration, sealing-type three-cavities ventilation joint proves to be a feasible method in bronchoscope.

Effect of wrist-ankle acupuncture on propofol dosage in painless bronchoscopy of elderly patients: A randomized controlled trial: 腕踝针对高龄无痛气管镜检查患者丙泊酚用量的影响:随机对照研究

ObjectiveTo observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism. MethodsA total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group, 30 cases in each one. In the wrist-ankle acupuncture group, wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room. In the control group, no any intervention was provided. The patients in two groups all received venous administration of midazolam, nalorphine and lidocaine and target controlled infusion of propofol. When the patient's consciousness was lost and the eyelash reflex disappeared, bronchoscopy was performed and the propofol dosage was increased accordingly during operation. Propofol dosage, vital signs and occurrence of adverse reactions, bronchoscopist satisfaction, operation time and recovering time were recorded in the patients of two groups. ResultsPropofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group, indicating the statistical differences (both P < 0.05). The vital signs were stable during bronchoscopy in patients of two groups. The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group, indicating the statistical differences (both P < 0.05). Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group, and the operation time and recovering time were lower than the control group, indicating the statistical differences (all P < 0.05). ConclusionIn painless bronchoscopy, wrist-ankle acupuncture may effectively reduce propofol dosage, alleviate respiratory suppression, reduce adverse reaction and shorten the recovering time in elderly patients.

无痛支气管镜诊疗麻醉现状与进展

无痛支气管镜诊疗麻醉现状与进展

Construction of a Risk Prediction Model for Fever After Painless Bronchoscopy.

BackgroundThe aim of this study was to construct a risk prediction model for fever after painless bronchoscopy.Material/MethodsA total of 188 patients were included, and a self-designed data collection form was used. By collecting relevant clinical data of patients before, during, and after the painless bronchoscopy, the influencing factors were analyzed through univariate analysis, and multiple logistic regression analysis was performed to construct the prediction equation, which was tested by ROC curve analysis.ResultsOf the 188 patients undergoing painless bronchoscopy, 49 had postoperative fever, and the incidence rate was 26.0%. The prediction probability model was: P=ex/1+ex, where e is the natural logarithm, X=−4.337+0.020×(CRP)+1.014 (whether the examination time was greater than 30 minutes)+1.912×(whether remifentanil was used during anesthesia)+1.514×(whether nausea or vomiting occurred during surgery or during recovery). The prediction sensitivity and specificity were 78.26% 76.72%, respectively.ConclusionsUse of this risk prediction model of fever after painless bronchoscopy can improve the recognition of people at high risk of postoperative fever, and it has good ability to guide clinical nursing observation and early screening of fever after painless bronchoscopy.

Investigation on development of bronchoscope diagnosis and treatment under general anesthesia in five provinces and cities in China

Objective To investigate the development of painless bronchoscope diagnosis and treatment under general anesthesia in five provinces and cities in China. Methods From December 2018 to February 2019, a self-designed electronic questionnaire was sent to related personnels in a department of anesthesiology in hospitals within the range of survey through the WeChat platform.The survey mainly included three aspects: basic information of hospital, development of bronchoscope diagnosis and treatment under general anesthesia and the specific management plan. Results Questionnaires were sent to 326 hospitals in total, and 261 hospitals responded with a response rate of 80.06%.Among the 261 hospitals involved in the survey, 34 hospitals responded that no related diseases were found, and thus the number of valid questionnaires was 227, and the rate of valid questionnaires was 87.0%.Among the 261 hospitals, 161 hospitals were tertiary hospitals, and 66 hospitals were secondary hospitals, with a constituent ratio of 70.9% to 29.1%.The average development rate of painless bronchoscopy was 34.8%, the highest rate was 54.0% in Beijing, and the lowest rate was 27.5% in Hebei province.The average development rate of painless bronchoscopy was significantly higher in tertiary hospitals than in secondary hospitals (P 0.05); the number of hospitals applying sevoflurane was larger as compared with that of hospitals applying desflurane(P 0.05). Conclusion At present, the development rate of painless bronchoscopy in China is lower, and the greatest difficulty in further development is the shortage of personnel.Bronchoscope diagnosis and treatment under laryngeal mask or under monitoring anesthesia is the most commonly used method in clinic, and general anesthesia under tracheal intubation is more suitable for highly difficult bronchoscope diagnosis and treatment.Opioids combined with propofol is the most commonly used anesthesia method. Key words: Bronchoscopy; Surveys and questionnaires

A preliminary study of different methods of anesthesia for painless bronchoscopy

Objective: This study aimed to explore a feasible method of anesthesia for painless bronchoscopy. Methods: A total of 120 patients receiving flexible bronchoscopy in Beijing Tiantan Hospital during the period from February, 8, 2018 to May, 4, 2018, were randomly divided into 3 groups, including group A (using lidocaine for local anesthesia), group B (using lidocaine + midazolam + fentanyl), and group C (using lidocaine + propofol + sufentanil). There were 41 patients in group A, 38 in group B and 41 in group C. The changes in systolic blood pressure, diastolic blood pressure, heart rate and pulse oxygen saturation(SpO(2)) in each group were recorded in different points of time. The safety of different methods of anesthesia was observed by recording vital signs and adverse events. Moreover, the visual analogue scale (VAS) was used to observe the patient's tolerance and satisfaction of the operation. Results: The intraoperative systolic blood pressure and diastolic blood pressure in group C were significantly lower than those in group A and B (P<0.05). Six cases in group C had hypotension, 3 of whom required vasoactive drugs. The differences of SpO(2) between the 3 groups showed no statistical significance (P>0.05), while patients in group C were prone to decrease in SpO(2). Eighteen patients in group C had hypoxemia during operation. But after treated with improving ventilation, the SpO(2) of those patients could be restored to normal. Compared with those in group C, patients in group A and group B showed significant discomfort, cough, and more pharyngeal pain (P<0.05). However, there were no significant differences in the degree of cough and pain between group A and group B (P>0.05). Most patients in group C had no uncomfortable sensation during the operation (P<0.05), and the willingness to re-examination was significantly higher than that in group A and group B (P<0.05). Conclusion: Propofol combined with sufentanil could achieve better painless effect, improve patient comfort and tolerance, and reduce intraoperative memory, but was prone to causing hypoxemia and hypotension. The decline of intraoperative SpO(2) could be corrected by establishing artificial airway, while the decrease of blood pressure could be corrected by applying vasoactive drugs, which were relatively safe.

Application of wide-angle overall security coordinate nursing on the patients of painless bronchofiberscope examination under laryngeal mask ventilation

Objective To investigate the application effect of wide-angle overall security coordinate nursing on the patients of painless bronchofiberscope examination under laryngeal mask ventilation. Methods Wide-angle overall coordinate nursing was conducted to painless bronchofiberscope examination cases under laryngeal mask ventilation since January, 2014 in this hospital. Before (from June, 2012 to December, 2013) and after (from January, 2014 to June, 2015) the implementation, 55 cases that received this examination in this hospital were used as the research objects.Before and after the implementation, the cases were divided into control group and experimental group to compare the difference of relevant observation indexes of two groups of painless bronchofiberscope examination cases after intervention. Results The positive rate of anxious emotion and complication occurrence rate of painless bronchofiberscope examination cases in experimental group after intervention were obviously lower than control group.The three major dimensional quantization scores of nursing satisfaction were obviously higher than control group (P<0.05). Conclusion Intervention conducted to the painless bronchofiberscope examination cases under laryngeal mask ventilation by wide-angle overall coordinate nursing can obviously improve the anxious emotion of patients, improve the examination security and nursing satisfaction. Key words: Nursing; Laryngeal mask airway; Painless bronchoscopy

Clinical study of the value in bronchoalveolar lavage in patients with severe lung infection by bed side painless fiberoptic bronchoscopy under chest CT guidance and mechanical ventilation

Objective To explore the effects of bed side painless fiberoptic bronchoscopy for bronchoalveolar lavage (BAL) under chest computed tomography (CT) guidance and mechanical ventilation in the patients with severe pulmonary infection (SPI) . Methods A total of 131 cases of SPI under mechanical ventilation support were randomly (random number) divided into CT group (C group) , chest X-ray examination group (X group) and without radiological examination group (N group) . The bronchoalveolar lavage (BAL) by using painless fiberoptic bronchoscopy with invasive mechanical ventilation was carried out in patients of these three groups. Vital signs and variables of respiratory mechanics of patients were monitored before and 1 h, 2 h, and 4 h after BAL and the time consumed for BAL was simultaneous recorded. Meanwhile, infection related biomarkers on the 3rdd and 5th d after BAL, positive detection rate of pathogenic bacteria, the time of invasive mechanical ventilation used during BAL and total duration of mechanical ventilation support were measured. Results During BAL and at 10 min after BAL, heart rate and respiratory rate of C group and X group were lower than those of N group (P 0.05) . One and two hours after BAL, peak inspiratory pressure (PIP) , work of breathing ventilation (WOBvent) and airway resistance (RAW) in C group and X group were lower than those in N group, therefore, dynamic compliance (Cdyn) in C and X groups was better than that in N group (P 0.05) . BAL time (BAL-t) in C group (16.81±2.62) min was shorter than that in X group (20.12±3.81) min and N group (23.69± 2.76) min, (P <0.05) . Three and five days after BAL, core body temperature, WBC and procalcitonin (PCT) in C and X group were lower than those in N group (P <0.05) , and those in C group was lower than those in X group (P <0.05) . Pathogenic micro-organism detection rate in C group (80.55%, 29/36) was higher than that in X group (72.09%, 31/43) and N group (59.65%, 34/57) (P <0.05) . Total mechanical ventilation time (MV-t) in C group (114.36±38.39) h was shorter than that in X group (132.07±42.51) h and N group (165.28±67.28) h (P<0.05) . Conclusions BAL by using painless fiberoptic bronchoscopy under chest CT guidance can effectively reduce the stress on patients with severe pulmonary infection supported with mechanical ventilation, decrease airway hyper-reactivity, shorten the BAL time, ICU stay and duration of mechanical ventilation, facilitate drainage of lung infection exudates and pathogen detection rate and improve efficacy of comprehensive treatment. Key words: CT chest; X-ray; Fiberoptic bronchoscopy; Bronchial lavage; Painless; Mechanical ventilation; Pulmonary infection; Intensive care unit

Application of laryngeal mask and endoscopic facial mask in painless elderly fiberoptic bronchoscopy patients

Objective To investigate the appropriate airway manage method in elderly painless fibreoptic bronchoscopy(FB)patients.Methods 60 patients scheduled for painless fibreoptic bronchoscopy were randomly divided into 3 groups,patients in group Ⅰ oxygen with nasal cannula,group Ⅱ with endoscopy facial mask and group Ⅲ double-tube laryngeal mask.Record bronchoscopy examination condition and systolic blood pressure(SBP)、diastolic blood pressure(DBP)、heart rate(HR)、pulse oximeter saturation(SpO2)just before bronchoscopy,2 min after insertion,biopsy or flushing,2 min after biopsy and leaving the operating room.The operation time,anesthesia time,SpO2 decline to 90％,85％ were also recorded.Results Patients in Group Ⅱ,Ⅲ experienced fewer intraoperative hypoxemia(Ⅰ 18; Ⅱ 16; Ⅲ 3)and operation suspension(Ⅰ 35; Ⅱ 5; Ⅲ 1,P＜0.01),the satisfaction for anesthesia was also higher than group Ⅰ(15％)(group Ⅱ 50％,P＜0.05;group Ⅲ 95％,P＜0.01).Conclusion Application of endoscopy facial mask,especially laryngeal mask in elderly painless fibreoptic bronchoscopy patients can reduce the incidence of intraoperative hypoxia,increase anesthesia satisfaction without increasing the anesthesia time. Key words: Laryngeal mask; Fiberoptic bronchoscopy; Anesthesia