The Use of Curare and Pentothal Sodium in Endoscopy

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The difficulties encountered in endoscopic examination of certain individuals are well known to all who are actively engaged in this type of work. In a short heavy-set person with a thick neck, it is often very difficult to obtain a satisfactory view of the larynx. In people who are excessive smokers and have a hyperactive gag reflex, it is very difficult to obtain sufficient anesthesia with topical applications alone for a satisfactory examination. This is also true of the hypersensitive, apprehensive person who lives in a state of nervous tension. When these patients submit to an endoscopic examination they are subjected to a maximum of psychic trauma, and in many instances the examination or operative procedure cannot be carried out satisfactorily.

The various general anesthetics now in common use have been employed at one time or another for endoscopic procedures. Certain disadvantages have accompanied the different agents employed:

  1. Instrumental manipulation of pharynx and larynx has frequently resulted in a laryngospasm.

  2. Deep anesthesia is required to produce sufficient relaxation to accomplish the examination.

  3. The deep anesthesia thus produced causes a prolonged recovery period. This precludes the possibility of the examination’s being accomplished on an out-patient basis.

Pentothal sodium anesthesia alone has been found to be very satisfactory for endoscopic procedures in the difficult patient. However, there are certain dangers and disadvantages to its use owing in part to the fact that it does not afford complete anesthesia. Any irritation in the pharynx and larynx of a patient anesthetized. . .



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