Nd-YAG Laser under Local Anaesthesia in Obstructive Endobronchial Tumours

Abstract

Thirty-eight neodymium yttrium aluminium garnet (Nd-YAG) laser sessions have been performed in 26 patients under local anaesthesia. The majority of patients had recurrences of inoperable non-small-cell lung cancer after radiotherapy. At evaluation, a subjective improvement of dyspnoea was noticed in 70% (18/ 26) of the patients, and in 54% (14/26) of the cases, a > 50% improvement of the airway lumen diameter was assessed at bronchoscopy. Haemoptysis subsided in 4 out of the 5 patients. On 2 occasions, the rigid scope was introduced to provide optimal control of minor bleeding during the laser performance. Neither respiratory failure, nor any treatment-related death has occurred. In our hands, Nd-YAG treatment under local anaesthesia was a feasible, effective and safe procedure

The anesthesia of trachea and bronchus surgery

“…In addition, general anesthesia with neuromuscular blockade, spontaneous ventilation with topical anesthesia or nerve blocks, apneic oxygenation, and jet ventilation are applicable techniques for rigid bronchoscopy (51,52). Any movement of the patient during bronchoscopy may result in serious injury, but the use of a neuromuscular blocker may be dangerous in patients with partial airway obstruction.…”