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October 26, 1957


JAMA. 1957;165(8):943-946. doi:10.1001/jama.1957.02980260029006

The general orotracheal anesthesia here described has many advantages over the topical anesthesia that has been traditional in bronchoscopy. The new technique as applied to the average adult includes premedication, about an hour before the time set for induction, by the intramuscular injection of 100 mg. of meperidine, 0.6 mg. of scopolamine, and 50 mg. of diphenhydramine. Induction consists of intravenous injection of 150 to 200 mg. of thiamylal followed rapidly by 40 mg. of succinylcholine; then an orotracheal tube is inserted and used for the administration of a 2 to 1 mixture of nitrous oxide and oxygen. Certain modifications are used in very old and very young patients. After experience with an initial series of 100 bronchoscopies with curare as the relaxant it was found that succinylcholine was much better, and it has been used in a second series of 100 bronchoscopies. The new technique has also been adapted for use in other surgical procedures that require excellent relaxation for short periods of time. It provides safety and comfort for the patient, permits the surgeon or bronchoscopist to do much better work, and reduces the emotional strain on all concerned.