For the past two and a half years we have been using general anesthesia for peroral endoscopy at the Long Island College Hospital. This method has as its basis the use of an ultra-short-acting intravenous barbiturate, an extremely short-acting muscle relaxant (succinylcholine), and a mechanical thoracoabdominal respirator. A description of this method of controlled passive respiration under general anesthesia is the subject of a separate paper. As a result of this type of anesthesia we have been able, in a series of approximately 200 cases, to visualize more distal bronchi than is usually possible with topical anesthesia. This is so because the patient is asleep, completely atonic, and is being adequately ventilated by the respirator. Therefore, the need for haste is eliminated; motion at the head and neck is possible through a wide range; the normal physiologic motion of the bronchi is present, and cough is absent; consequently, it becomes
BIENIAS GB, POLISAR IA. Anatomy of the Bronchial Tree: A Presentation of an Extension of the Jackson-Huber Nomenclature of the Tracheobronchial Tree. AMA Arch Otolaryngol. 1958;68(4):454–459. doi:10.1001/archotol.1958.00730020472008
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.