Initially, endoscopy was primarily therapeutic, with its use devoted to the removal of foreign bodies. Although this function has retained its importance, diagnostic endoscopy is now the major practice. Tremendous advances in equipment and technique have been made in the past two decades, making peroral endoscopy indispensable to the diagnosis of diseases of the respiratory and alimentary tracts.
Unfortunately, the strides in operative technique have not been accompanied by comparable advances in anesthetic procedures. Although topical anesthesia is used successfully in many endoscopic procedures, it is frequently inadequate, often causing reluctance in the patient to accept the procedure or hesitation on the part of the referring physician to subject his patient to it.
To compensate for the failings of topical anesthesia, general anesthesia has been tried. Inhalation anesthetics or the intravenous short-acting barbiturates, following topical agents, were initially suggested, but those held too many hazards. Then topical anesthesia, combined with
ALVER EC, LEEK JH. Induced Paralysis for Endoscopic Procedures: A Preliminary Report. AMA Arch Otolaryngol. 1955;62(4):399–405. doi:10.1001/archotol.1955.03830040053009
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