Thiopental with succinylcholine and topically applied tetracaine; a more ideal anesthetic for peroral endoscopy.

Abstract

GENERAL anesthesia for peroral endoscopy has always presented many problems. The use of inhalants, ether and/or cyclopropane, is time-consuming and fraught with the potential danger of explosion, due to a spark from the endoscope light, and of anoxic episodes. Furthermore, the maintenance of the desired level of anesthesia in prolonged procedures is difficult or impossible. 1 The use of intravenous anesthetics eliminates the danger of explosion and facilitates the maintenance of the desired level of anesthesia, but it introduces new problems, i. e., prolonged postoperative depression and the serious danger of laryngospasm. 2 The latter has been obviated to a certain extent by preceding the general anesthesia with topical anesthesia and utilizing a curariform drug in combination with the intravenous barbiturate. 3 However, the addition of curare adds to the postoperative depression, thus necessitating exceedingly watchful postanesthesia nursing care, and increases the risk of postendoscopic complications. The ideal anesthetic for