Peri-operative care of patients undergoing robotic-assisted bronchoscopy under general anaesthesia - a single-centre...

Bronchoscopic procedures are increasingly performed with shape-sensing robotic-assisted bronchoscopy under general anaesthesia, allowing biopsy of small and distal pulmonary lesions. We performed a retrospective cohort study at a single centre of patients undergoing robotic bronchoscopy to describe the peri-operative care. The primary outcome measure was post-procedural length of hospital stay, with secondary outcomes including complication rates and diagnostic success of biopsy. A total of 200 patients were recruited over a 12-month period. Median ([IQR] range) post-procedural length of stay was 4 h ([2.5-24.5] 0.5-75) with 106/200 (53%) of patients performed as a day case. Cardiorespiratory comorbidities were common, 65% of patients had an ASA physical status 3 or 4. Higher ASA physical status and chronic obstructive pulmonary disease were associated with increased post-procedural admission rate. All patients underwent general anaesthesia with target-controlled infusion of propofol. Neuromuscular blocking agents were used in 194/200 (97%) and remifentanil was used for 185/200 patients (93%). Median PEEP was 10 cmH₂O (range 5-15 cmH₂O). The incidence of peri-procedural complications requiring intervention was 6%. Our findings suggest that robotic-assisted bronchoscopy could be delivered safely as a day case procedure in a population with a high incidence of comorbidities, with low peri-procedural complication rates.