Bronchoscopy is a diagnostic test that is used to view the airways, throat and larynx. This procedure can also facilitate removal of a growth or obstruction from the airway. Bronchoscopy is useful in diagnosing lung diseases and lung cancer. Any growth in the airways can be treated or removed. Other diagnostic tests such as CBC test, arterial blood gas test and PFT may be prescribed before embarking on bronchoscopy. The secretions in the mouth and airways are dried up with suitable medications. The vocal chords are also numbed. Fluroscope is also used to capture the images on a monitor. Avoid eating or drinking for a few hours prior to a bronchoscopy procedure. There might be blood in the sputum in case of biopsy.
Flexible bronchoscope allows a better view of the smaller airways and permits biopsy procedure too. This is called a transbronchial biopsy. Local anesthesia is often sprayed into the nose and mouth.
Rigid bronchoscope often necessitates the patient to be anesthesized and is resorted to when large samples need to be taken for biopsy and to remove pieces of food or dilating the airway. Use of laser is possible for removal for obstructions.
Abnormal results of bronchoscopy may be indicative of lung cancer, tumor, enlarged lymph nodes, ulceration or abnormality in the bronchial wall. Bronchoscopy is prescibed in cases where the patient coughs up blood or chest x-ray shows abnormal findings. If a person has inhaled a foreign body into the lung, bronchoscopy can help in removing it.
Anesthesia is a procedure that is administered to control pain, heart rate, blood pressure and other vital parameters during a surgical procedure. It is temporary state which allows the patient to recover and gain control of his coordination a few hours after a surgical procedure.
Anesthesia is an exact procedure which requires theoretical and practical expertise. Any kind of dosage variation can be fatal to the patient. During general anesthesia, patients are advised to abstain from eating and drinking 12 hours before the procedure as it may lead to aspiration associated complications during the procedure. Thorough examination of the patient history is done to evaluate for drug sensitivity and allergic patterns with respect to the type of anesthesia administered. Anesthetics such as inhalants or IV forms are given depending upon the type of surgical procedure.
General anesthesia is administered during complicated procedures such as cardio thoracic surgery, oncogenic or organ specific surgery. In this procedure, the patient goes into a stage of total unconsciousness with administration of anesthetic gases and intravenous anesthetics such as halothane, Sevoflurane, Enflurane, Desflurane, Isoflurane, Propofol, etomidate and thiopental. Some anesthetics such as Propofol are hypnotic in nature. It has been widely used because of its nature to bring back the patient to conscious state a few hours after the surgical procedure. In addition to the inhalant and intravenous forms of anesthesia which are administered, neuromuscular blockage is also required as it helps in respiratory ventilation along with intubation. Most of these neuromuscular blockade agents are derived from curare compounds which is a skeletal muscle relaxant.
Local anesthetics are either administered as a combination with general anesthetics are as a post-operative anesthetic agent. Most of the local anesthetics are amides and esters. Some of the local anesthetic amides include lidocaine, prilocaine, ropivacaine and etidocaine. The ester forms of these anesthetics include tetracaine, procaine, cocaine and benzocaine. Local anesthetic drugs are given directly in the region where the surgical procedure has to take place. Most dental procedures involve the administration of local anesthetics. The patient is conscious and experiences numbness only in the region where the procedure is being done.
This form of anesthesia is given to block pain in a larger area of the body where the procedure is done. Patient is sedated in most cases. Regional anesthetic drugs usually work on the principle of nerve block caused in the peripheral region. This includes a procedure called spinal anesthesia where the drug is administered in a specific area of the spine to numb the corresponding region of the body. Regional anesthesia is administered at a specific location to numb the region for surgical intervention. Local anesthetics are administered either in the topical or injectable form to desensitize the area of surgical intervention.
Risk factors of anesthesia
Malignant hyperthermia is one of the rare yet life threatening complications of anesthesia. This adverse reaction is caused when succinyl choline (muscle relaxant) is administered. In this reaction, the muscle fibers of the body tend to dissociate from each other. Spinal and epidural anesthetic procedures have headaches as side effects due to the leakage of cerebrospinal fluid from region of injection. Nausea, vomiting and nerve damages are some of the predominant side effects of anesthetic procedures. These are controlled by administration of IV medications. In some patients, the insertion of endotracheal tube during procedures such as bronchoscopy may lead to sore throat for a few days. Apart from all the presumptive risk factors and side effects of anesthetic drugs, some have toxic effects on liver and kidneys. In such conditions, patients are examined for tolerance and toxicity before administering anesthetic gases such as halothane.
Tuberculosis, TB or Pulmonary tuberculosis is a bacterial contagious disease caused by Mycobacterium tuberculosis. Persons with weakened immune system, infants and elderly people are at higher risk for tuberculosis. You can be at greater risk if you are in frequent contact with persons suffering TB. Poor nutrition and sanitation contribute to the risk factor. Many drug-resistant strains of TB have made it more difficult to treat the disease. Pulmonary tuberculosis shows up with symptoms like fatigue, fever, cough with mucus and blood, chest pain, difficulty in breathing and unexplained weight loss. A person suffering TB will have enlarged lymph nodes and pleural effusion. Bronchoscopy, chest x-ray and sputum culture can aid diagnosis of pulmonary tuberculosis. Pulmonary TB is treated with Isoniazid, Rifampin, Ethambutol, Streptomycin or Moxifloxacin. Treatment usually lasts for 6 months or longer.
Extra pulmonary tuberculosis or Miliary tuberculosis
Tuberculosis can also affect other parts of the body such as bones, lymphatic system, central nervous system and genital or urinary system. Disseminated tuberculosis or Miliary tuberculosis is a contagious bacterial infection that has spread from the lungs to other parts of the body through the blood or lymph system. This type of TB can also affect the larynx, skin and pericardium too.
Bibliography / Reference
Collection of Pages - Last revised Date: January 20, 2019