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Review
. 2018 Aug;10(Suppl 23):S2738-S2743.
doi: 10.21037/jtd.2018.02.46.

Anaesthesia management for bronchoscopic and surgical lung volume reduction

Bastian Grande  1 , Torsten Loop  2
Affiliations
Review

Anaesthesia management for bronchoscopic and surgical lung volume reduction

Bastian Grande et al. J Thorac Dis. 2018 Aug.

Abstract

Optimizing the patient's condition before the lung volume reduction (LVR) according to recommendations by American College of Cardiology/American Heart Association (ACC/AHA) guideline on perioperative cardiovascular evaluation is mandatory. Implementation of a multimodal analgesia concept and the use short-acting anaesthetics enhances recovery and avoids postoperative pulmonary complications. Normovolemia, normothermia, lung protective ventilation and an evidence-based concept of airway management (i.e., double-lumen tube, bronchus blocker) are suggested for intraoperative management of surgical lung volume reduction (SLVR). General anaesthesia (using remifentanil, propofol and mivacurium) with an i-gel® supraglottic airway device should be used for bronchoscopic lung volume reduction (BLVR). Jet ventilation through rigid bronchoscopy or with a jet catheter may be an alternative concept. Experienced consultants should perform anaesthesia for LVR.

Keywords: Lung volume reduction surgery (LVRS); anaesthesia management; bronchoscopic lung volume reduction (BLVR).

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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