Introduction
bronchial tuberculosis, bradycardia, airway tumor, spasm, choking, cough, glottis, airway reactions, hypotension
CHOKING, CHOKING, DISEASES
In recent years, fiberoptic bronchoscopy has been widely used in the diagnosis and treatment of tracheal parenchymal diseases. The main indications of fiberoptic bronchoscopy are chronic cough of unknown cause, such as suspected bronchial tuberculosis and airway tumor [Fiberoptic bronchoscopy need to be performed with medications that relieve spasm of the airway smooth muscle, dilate the airway, and reduce the secretion of airway glands. However, the most important drugs are sedatives and analgesics, which can eliminate airway reactions such as choking. Choking is caused by mechanical stimulation of the airway during surgery, such as fiber bronchoscopy contact of the glottis or airway induced choking. General anesthesia is very important in reducing the difficulty of examination operation and improving the safety, tolerance, and comfort of patients [At the same time, because no tracheal intubation was performed during bronchoscopy examination, if the anesthesia was too deep, it will cause a passive situation for anesthetists and fiberoptic bronchoscope operators. Therefore, anesthesiologists have been exploring the optimal combination of anesthetic drugs to achieve appropriate deep sedation while providing analgesia. For example, Bermejo et al. found that moderate sedation with dexmedetomidine-remifentanil is safer than deep sedation with propofol-remifentanil for endobronchial ultrasound [Ketamine is a noncompetitive antagonist of the N-methyl-d-aspartic acid (NMDA) receptor and has sedative and analgesic properties when administered in subanesthetic doses [Clinical trials reported that esketamine can reduce bradycardia and hypotension caused by propofol while exerting analgesic effect [