Subcutaneous Dissociative Conscious Sedation (sdcs) An Alternative To General Anesthesia For Rigid Bronchoscopy: A Novel Approach | 12428
Otolaryngology: Open Access
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Rigid bronchoscopy for treatment of tracheal stenosis, as a noninvasive therapeutic option has increased significantly. Anesthesia for
tracheal dilatation is challenging because the airway needs to be shared with the interventionist. Communication and coordination
between anesthesiologist and interventionist is crucial. Anesthesia could be induced by inhalation anesthetics or intravenous agents. Jet
ventilation is another modality adopted by many centers. Maintaining spontaneous ventilation is of prominent importance to increase the
security of the airway. In this study, 25 patients with known tracheal stenosis, scheduled for tracheal dilatation, underwent "Subcutaneous
Dissociative Conscious Sedation�. sDCS was induced by subcutaneous ketamine 0.5 mg/kg, intravenous morphine sulfate 0.15 mg/kg(
gradually in 5 minutes) and intravenous fentanyl 1-3ug/kg, titrated until the patient fell asleep. The tongue and pharynx were anesthetized
with lidocaine spray (10%). About 10 minutes after the subcutaneous injection of ketamine, rigid bronchoscopy was started. Extra doses
of fentanyl 50 ug, were administered if the patient wasn't cooperative enough. Patients were evaluated for hemodynamic stability (heart
rate and blood pressure), oxygen saturation (Spo2), patient cooperation (obedient to open the mouth for insertion of the bronchoscope),
patient comfort (remaining moveless), hallucination, nystagmus and salivation. Rigid bronchoscopy and tracheal dilatation performed
successfully in all patients. There were no significant hemodynamic changes, no oxygen desaturation and no complication during the
In conclusion Subcutaneous Dissociative Conscious Sedation (sDCS) is an acceptable and safe method of anesthesia for rigid
bronchoscopy and it can be suggested as a noninvasive substitute for general anesthesia in rigid bronchoscopy.
Mihan J. Javid has completed her M.D at the age of 24 from Tabriz University of Medical Sciences and post-doctoral studies from Tabriz University of Medical Sciences. She is director of Intensive Care Unit. She has more than 20 publications and more than 6 innovations in medicine. She won the award of ?The Best Researcher? in Iranian festival of the Best woman researcher in 2004.
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