Sedation, anaesthesia and monitoring for bronchoscopy.

Management of the airway for paediatric bronchoscopy requires joint planning and constant communication between the bronchoscopist and the anaesthetist. At all times maintenance of an effective airway must be the first priority. All sedative drugs compromise the patency of the airway to some extent in addition to effective ventilation by the patient. Thus, a specific individual must be dedicated to ensure adequacy of airway and ventilation throughout the procedure. Since sedation and anaesthesia are merely two points on a continuum of reduced central nervous system activation, an anaesthetist most appropriately performs this role. There is a range of drugs that may be utilised to induce sedation and a variety of airway adjuncts, which will be described. Any individual using them should be familiar with their advantages and disadvantages and be capable of managing any predictable or unusual complications.