According to Jackson,1 the majority of physicians performing bronchoscopy and bronchography employ local analgesia with the patient cooperatively awake, and many use no anesthesia at all for children.
A number of reasons are advanced for not using general anesthesia:
(a) It is too dangerous.
(b) Extreme depth of anesthesia, almost to respiratory arrest, is required to produce relaxation sufficient to insert the bronchoscope. This produces delayed postoperative recovery and morbidity, especially when thiopental (Pentothal) sodium is used.
(c) Insufflated ether is of questionable value, since it creates a fog at the distal end of the bronchoscope which distorts visual acuity, and gases such as nitrous oxide and ethylene are rather impotent by comparison.
(d) General anesthesia is usually fluctuant, with a "see-sawing" plane, resulting in coughing, vomiting, reflex struggle, and ultimate trauma to the trachea, larynx, and teeth. This necessitates speed on the part of the bronchoscopist, and frequently
SHANE SM, ASHMAN H. A METHOD OF GENERAL ANESTHESIA FOR BRONCHOSCOPY AND BRONCHOGRAPHY. AMA Arch Otolaryngol. 1955;62(3):319–321. doi:https://doi.org/10.1001/archotol.1955.03830030085016
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