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February 1956

Reaction to Cocaine Used as Topical Anesthetic in Bronchoscopy: Study of One Thousand Cases

Author Affiliations

From the Departments of Anesthesia and Surgery, Veterans Administration Hospital, Wood, Wis., and the Marquette University School of Medicine.

AMA Arch Otolaryngol. 1956;63(2):115-119. doi:10.1001/archotol.1956.03830080001001

The necessity for a critical evaluation of the toxicity of local anesthetic agents used in endoscopy was previously expressed by us.1 As a series parallel to and comparable with the previous group of patients reviewed, in whom tetracaine hydrochloride was utilized as the anesthetic agent, 1000 consecutive diagnostic bronchoscopies on 956 adult patients in whom cocaine hydrochloride was used to induce anesthesia were similarly studied from January, 1950, to December, 1954.

METHODS AND RESULTS OF STUDY  As in the previous study, each of the patients herein reviewed was carefully evaluated before endoscopy by clinical methods, and these data were summarized on special "bronchoscopy work-up sheets." In addition, each patient underwent preoperative skin-testing by intradermal 0.1 cc. wheal injections of 1: 1000 cocaine, 1: 1000 tetracaine, and isotonic saline solutions, and the results of the three injections were read in 20 minutes and recorded on the work-up sheets; recordings of

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