On occasions, fortunately infrequent, every endoscopist has had the trying and often traumatic experience of being unable to obtain sufficient cooperation from a patient to permit satisfactory endoscopy. This lack of cooperation may be manifested by either an unwillingness or an inability to relax the jaw, to keep the tongue and epiglottis quiet, to relax the neck and to keep the pharynx quiet. In such persons the cricopharyngeus muscle is often in a spastic state.
Many endoscopists have attempted to circumvent the aforementioned obstructions to a completely satisfactory examination by employing general anesthesia. Anesthesia has been produced with tribromethanol in amylene hydrate, given by rectum; with pentothal sodium (the monosodium salt of 5-ethyl-5-[1-methylbutyl] thiobarbituric acid) or evipal sodium (sodium N-methyl-cyclohexenyl-methyl barbiturate), injected intravenously, and with various inhalation agents. Although endoscopic procedures can be performed with the patient anesthetized by any of these methods, there are a few significant disadvantages to
CULLEN SC, TRAPASSO AJ. USE OF CURARE TO FACILITATE ENDOSCOPY: A PRELIMINARY REPORT. Arch Otolaryngol. 1943;38(4):347–349. doi:10.1001/archotol.1943.00670040361006
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