Background and Goal of Study: Interventional rigid bronchoscopy procedures are very effective ways of treating airway lesions such as stenosis due to a tumor, tracheoesophageal fistula or foreign body. However, spontaneous respiration must be maintained during rigid bronchoscopy[1]. The aim of our study was to evaluate anesthetic management using dexmedetomidine and remifentanil and compare it with that by interventional rigid bronchoscopy procedures.
Methods: Anesthetic data for 54 patients undergoing interventional rigid bronchoscopy procedures between April 2008 and December 2015 were reviewed retrospectively. Dexmedetomidine was used in 36 patients (group D) whereas remifentanil was used in 18 (group R). We evaluated: patient characteristics; use of other anesthetic agents and cardiovascular agonists; time to insertion of rigid bronchoscopy from the induction of anesthesia; time to the end of anesthesia from completion of the surgical procedure; postoperative status of the airways. We employed the unpaired t-test and chi-square test between the two groups, and p<0.05 was considered significant.  
Results: Propofol and local anesthetic were used in all cases. No significant differences were found between the two groups with regard to propofol dose (p=0.257), time to insertion of rigid bronchoscopy from the induction of anesthesia (p=0.119), or in the time to the end of anesthesia from completion of the surgical procedure (p=0.199). Requirements for fentanyl (μg) (0.22±0.13 vs. 0.14±0.13, p=0.039) and of vasopressor (%) (55.6 vs. 17, p=0.006) in group D were significantly more than those in group R. There was no significant difference between groups with respect to postoperative requirements of a supraglottic airway device or tracheal tube (p=0.540). 
Conclusions: Before interventional rigid bronchoscopy procedures, local anesthetics are sprayed onto the airways for intubation, and sedation (using propofol or volatile anesthetics) is necessary. Analgesic use relieves stimulation by surgery and leads to stable management of anesthesia[1]. Dexmedetomidine and remifentanil can be used safely in interventional rigid bronchoscopy if the characteristics of each drug are considered carefully.

Anesthetic management for interventional rigid bronchoscopy, compared with dexmedetomidine and remifentanil