Anesthesia in peroral endoscopy, especially general anesthesia in esophagoscopy and gastroscopy.

Abstract

THE MAJORITY of peroral endoscopic examinations can be made with local anesthesia or without anesthesia without a great deal of discomfort to the patient and with satisfactory operative results. Use of local anesthetic agents is attended with a minimal amount of risk, but alarming and sometimes fatal reactions may follow their application. The comparative risk involved in local and general anesthesia is debatable, and the choice of an anesthetic agent cannot be made on the basis of risk alone. Except under unusual conditions and for solution of especially troublesome problems, we have found that bronchoscopic examination should be made in small children without anesthesia and in adults with local anesthesia. Employment of sedatives preoperatively is usually advisable in case of children. In case of adults, administration of barbiturates preoperatively lessens the likelihood of reaction to local anesthetics, but it is not desirable to use so much sedation that the patient