Ever since the introduction of bronchoscopy by Killian in 1897, the use of local anesthesia has been the method of choice for this procedure. However, there is a small group of patients who are either unwilling or unable to cooperate or relax sufficiently, so that the procedure becomes a traumatic experience to both the patient and the surgeon. Needless to say, these cases are frequently unsatisfactory and diagnostic failures. In these cases, the use of a general anesthesia becomes a necessity. The use of an inhalation anesthesia, especially in adults, was a prolonged procedure which was fraught with danger. The patients usually required deep anesthesia to get the necessary relaxation. The surgeon was always competing with the anesthetist for the airway. In patients with a short, thick neck, the danger of respiratory obstruction was always present. For this reason, the use of general anesthesia in adults was never popular.
PANG LQ. Bronchoscopy Under General Anesthesia: A Simplified Safe Method. Arch Otolaryngol. 1962;75(4):342–345. doi:10.1001/archotol.1962.00740040351007
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