[Anesthesia for tracheobronchial laser surgery]

Laser, performed using a rigid bronchoscope, permits the re-establishment of a sufficient tracheal airway diameter. This procedure requires a 15 to 60 minutes general anaesthesia including a neuromuscular blockade, a high frequency jet ventilation being delivered via the side channel of the bronchoscope. Concerning an adult patient of an average weight, presetting of the ventilator includes a supply pressure of 3 or 4 bar, a low I/E ratio and a frequency ranging between 60 and 120 cycles/min. During laser resection, the inspired oxygen concentration should always be less than 50 per cent to limit the risk of combustion. Oxygen desaturation episodes are related either to the placement of the bronchoscope in a mainstem bronchus or to a preexisting COPD. A few hours stay in a recovery room in mandatory knowing the risk of redo or reintubation.