ANESTHESIA FOR ENDOSONOGRAPHY OF MEDIASTINUM ― WHAT IS THE CHOICE?

I.V. Sivokozov1-3, D.V. Sazonov2, D.V. Dedushkin3, E.N. Artemkin3

1Central Research Institute of Tuberculosis, Moscow

2Federal Scientific and Clinical Center of Specialized Medical Assistance and Medical Technologies FMBA of Russia, Moscow

3The Main Military Clinical Hospital named after acad. N.N. Burdenko, Moscow

Sivokozov I.V. ― researcher of the endoscopy department of Central Research Institute of Tuberculosis

2 Yauzskaya alley, Moscow, Russian Federation, 107564, tel.: (499) 785-91-56, +7-967-045-79-05, e-mail: sivokozov@bronchology.ru

Abstract. There are a lot of anesthesia types for endoscopic ultrasound investigation of mediastinum. Local anesthesia can be recommended in case of transesophageal investigation, when a short-time (less than 15 minutes) procedure is expected, without left adrenal gland biopsy. Sedation can be a choice in suspected prolonged procedure (more than 15 minutes for EBUS or EUS approaches), multiple biopsies or technically complicated interventions. Also, this anesthesia type can be used in case of left adrenal gland biopsy. EBUS can be performed in general anesthesia with less difficulties using laryngeal mask, comparing to endotracheal tube. Performing EBUS via rigid bronchoscopy can be recommended only in cases of classical staging (4R-7-4L), or biopsy of hilar regions. Investigation of anterior and upper mediastinum is better performed using laryngeal mask.

Key words: endoscopic ultrasound, sarcoidosis, lung cancer, bronchoscopy, anesthesia.