During the Procedure

• The bronchoscopy is performed in 1 of 3 areas:
  
  
  • A special room designated for such procedures
  
  
  
  • An operating room
  
  
  
  • An intensive care unit


• You will be given antianxiety and antisecretory medications (to dry your mouth and membranes), generally atropine (Atropair, I-Tropine) and morphine (Duramorph, Oramorph, Roxanol), a half-hour before the procedure.



• During the procedure, doctors provide an agent such as midazolam (Versed) to sedate you, although you remain conscious. Lidocaine also can be used to anesthetize your upper airways.



• You will be monitored during the procedure with periodic blood pressure checks, continuous ECG monitoring of your heart and oxygen measurement. Monitoring is particularly important when you remain conscious during the procedure.



• The doctor can insert a flexible bronchoscope through either your nose or mouth. You can be either sitting or lying down.



• Once the bronchoscope is inserted into your upper airway, the doctor will examine your vocal cords. The doctor continues to advance the instrument to the trachea and on down, examining each area as the bronchoscope passes.



• If doctors discover an abnormality, they may sample it, using a brush, a needle, or forceps.
  
  
  • They also may sample a large number of alveoli, the air sacs in your lungs.
  
  
  
  • Doctors can obtain a specimen of lung tissue (transbronchial biopsy) often using a real-time x-ray (fluoroscopy).