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Abdelmalak, B. B., Doyle, D. J. Updates and controversies in anesthesia for advanced interventional pulmonology procedures. Curr Opin Anaesthesiol 2021: 34 (4) 455-463

October 16, 2021

Purpose of review
Advanced bronchoscopic procedures continues to grow, and are now commonly used to diagnose and/or treat a variety of pulmonary conditions that required formal thoracic surgery in past decades. Pharmacologic developments have provided new therapeutic options, as have technical advances in both anesthesia and interventional pulmonology. This review discusses technical and clinical issues and advances in providing anesthesia for advanced bronchoscopic procedures. It also discusses some controversial issues that have yet to be fully resolved.

Recent findings
We discuss anesthetic considerations for new procedures such as the new technology used in electromagnetic navigation bronchoscopy, and bronchoscopic cryotherapy. We also review new ventilation strategies as well as pharmacologic advances and recent trends in the utilization of anesthetic adjuvants, and the use of shortacting opioids like remifentanil, and alpha agonist sedatives such as dexmedetomidine.

The anesthetic framework and the discussions presented here should help forge effective communication between the interventional pulmonologist and the anesthesiologist In the Bronchoscopy Suite nonoperating room anesthesia with the goal of enhancing patient safety.

airway management, anesthesia for bronchoscopy, endobronchial ultrasound and electromagnetic navigational bronchoscopy, interventional pulmonology, jet ventilation