How is bronchoscopy done? Few know, but the word sounds intimidating. And not in vain. After all, this is a complex procedure that has certain risks. Conduct it in a sterile operating room, observing all appropriate precautions.
How do bronchoscopy of the lungs
Reviews of patients who went through this procedure about how bronchoscopy of the bronchi is done is reassuring. The most important thing is that it doesn’t hurt at all, does not last long, and if carried out correctly, it does not leave negative consequences.
The huge diagnostic and therapeutic capabilities of the bronchoscope more than compensate for the unpleasant sensations of the patient during the procedure. And yet, what is diagnostic and therapeutic bronchoscopy: how do each of these procedures do?
At the moment, bronchoscopy is the most effective and visual method for examining and conducting some therapeutic measures of the internal cavity of the lungs, bronchi and trachea. After introducing an optical bronchoscope inside, the doctor on the monitor can observe a complete picture and make an accurate diagnosis.
In addition to diagnostic, medical bronchoscopy is also performed. Reviews of former patients are direct evidence that the healing properties of this procedure are very effective: the rapid removal of foreign bodies and pathological substances from the bronchi, the introduction of the necessary medications.
Types of bronchoscopy
How is bronchoscopy stiff, and how does it differ from flexible? A rigid (rigid) bronchoscope is a system of hollow stiff tubes with a flashlight and a camera on one side and a manipulator on the other. A stiff bronchoscope procedure is required to detect a foreign body in the bronchi or airways or to stop bleeding from the respiratory organs.
A rigid bronchoscopy is performed under anesthesia. Since general anesthesia, the patient does not experience discomfort, does not move and does not interfere with the doctor's concentration.
Often, a rigid bronchoscope is used by emergency doctors and resuscitation teams in first aid, for example, to a drowned man. This is a quick and effective way to remove fluid from the lungs. If various pathologies are detected during the diagnosis, a rigid bronchoscope allows the doctor to eliminate them immediately on the spot. With flexible bronchoscopy, this is not possible, the doctor will subsequently have to re-enter the device into the patient's airways.
In the absence of direct indications for a rigid type of bronchoscopy, doctors try to use an elastic fibrobronchoscope, in which case local anesthesia is most often enough. It is a smooth tube made of an optical cable with an LED, a video camera at one end and a control lever at the other.
Although the flexible type of bronchoscopy is considered primarily diagnostic, a special catheter inside the fibrobronchoscope, if necessary, will allow you to remove fluid from the bronchi or apply medication to them. It easily and with minimal trauma to the mucous membranes penetrates the farthest parts of the respiratory organs.
Anesthesia: general or local?
General anesthesia can be prescribed with flexible bronchoscopy, depending on the characteristics of the patient's psyche (childhood, unstable psyche, state of shock and stress).
Local anesthesia involves the use of a solution of lidocaine in the form of a spray, they are first irrigated with the sinuses, nasopharynx, and then, as the apparatus moves, the larynx, trachea and bronchi. Lidocaine not only relieves pain, but also suppresses vomiting and coughing reflexes. Only local anesthesia is recommended in old age or if the patient has severe diseases of the cardiovascular system.
Conditions for the use of bronchoscopy
Diagnostic bronchoscopy is required in the following cases:
- with tuberculosis;
- smoking experience of 5 years;
- suspected lung cancer;
- atelectasis of the lung;
- bleeding
- respiratory obstruction;
- prolonged coughing of unknown origin;
- pathology identified in x-ray images (inflammation, nodes, seals).
In addition, therapeutic bronchoscopy is prescribed:
- to extract foreign bodies from the respiratory system;
- removal of neoplasms that block the airways;
- stent placement on the airways when they are blocked by tumors.
Preparing the patient for the study
What is bronchoscopy and how to prepare for it? As a rule, patients learn about this only after realizing the inevitability of the procedure and reading all kinds of literature on how to do bronchoscopy. The positive effect of the procedure depends on the qualifications and responsible approach of the doctor and the thorough preparation of the patient.
It will be necessary to first pass several tests and undergo examination (general and biochemical analysis of blood, urine, functional pulmonary test, chest x-ray, electrocardiogram of the heart and some others, in accordance with the patient's disease and the purpose of the study). The doctor will conduct a conversation with the patient, tell you where bronchoscopy is done, how the examination will be performed, for which you should prepare yourself mentally in advance.
In addition, he will offer to fill out a questionnaire, which should indicate:
- existing heart disease;
- clotting problems;
- autoimmune diseases;
- drugs for which an allergic reaction is possible;
- medications taken;
- chronic and acute diseases;
- the state of pregnancy and other features of your body that may affect the course of the bronchoscopy procedure.
During a routine examination, the patient is forbidden to eat food, alcohol, smoke for at least 8 hours. The human stomach should be empty. It is permissible to take laxatives in advance or put a cleansing enema.
Patients with asthma are allowed to take an inhaler with them to the operating room. Many patients experience and are very nervous before the study. In this case, the person is recommended to take mild sedatives. The patient’s emotional state is very important - so that during the procedure he is calm and relaxed - otherwise it will be difficult for the doctor to make smooth and very accurate movements, which determine the effectiveness of the study.
Does it hurt to do bronchoscopy
Contrary to expectations, the process of conducting bronchoscopy is carried out painlessly. When inserted into the tube, a lump in the throat, nasal congestion, numbness of the palate and difficulty in swallowing are felt. The patient's breathing is not difficult, since the diameter of the tube is very small.
After the procedure
The patient is fully recovering and can leave the hospital building, take food, water already 2-3 hours after the end of the procedure. It is undesirable to smoke and take alcohol during the first two days. If sedatives were taken, then on this day it is better not to drive and do not drive a vehicle, since they dull the attention, speed and reaction of a person.
Contraindications
Like any other medical procedure, bronchoscopy has a number of contraindications.
1. Relative, if the case is urgent and there is no way to make a diagnosis by another method:
- pregnancy (2nd and 3rd trimester);
- advanced diabetes mellitus;
- enlarged thyroid gland;
- alcoholism;
- bronchial asthma.
2. Absolute, if irreversible harm to health is possible:
- stage of decompensation of one of the diseases of the human cardiovascular system (myocardial infarction, aortic aneurysm, heart disease, heart rhythm disturbances, hypertension);
- respiratory failure or obstructed patency of the bronchial system;
- thrombosis of blood vessels - the brain or pulmonary;
- psycho-neurological diseases of the patient (epilepsy, schizophrenia);
- pain in the abdominal cavity of various origins.
Possible complications
The procedure for conducting bronchoscopy is quite complicated, with proper conduct of unpleasant sensations, only a small tickle in the throat remains. However, no one is safe from accidents, and in the process complications may arise:
- Mechanical damage and even puncture of the lung, bronchus and trachea can lead to bleeding.
- Before the procedure, an allergic test is mandatory, for this a small dose of anesthetic substance is administered to the patient. But sometimes it happens that the test was successful, and allergies are already evident during the procedure, with an increase in dose. Laryngeal edema and anaphylactic shock are possible.
- The larynx of each patient is individual, sometimes due to the anatomical features, a bronchoscope can damage the vocal cords.
- If the doctor's recommendations are not followed after the procedure, a significant deterioration in health and bleeding is possible.
So, having studied all possible indications, contraindications and risks, the general practitioner or pulmonologist determines the advisability of conducting bronchoscopy, discusses it with the patient and, with his written consent, sets the day and hour of the procedure.