Laryngo-Tracheo-Bronchial Anesthesia for Bronchoscopy and Bronchography with Pontocaine

¹ Chief of Thoracic Medicine, St. Francis Hospital, Trenton, New Jersey. Associate in Medicine, Graduate School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

1) Review of the literature shows that all authors committing themselves on the actual quantity of pontocaine used for bronchoscopy or bronchography are using far more of the drug than is recommended by the manufacturer. In one case as much as fifteen times the recommended dose was used for bronchography.

2) Unnecessarily large amounts of pontocaine are used for these procedures because of the inadequacies inherent in present techniques and instrumentarium.

3) A "one-hand" micro-atomizer and mirror-cannula which permit use of small doses of pontocaine are described.

4) A technique which makes possible bronchoscopy and bronchography with the use of 20.00 mgms. (1 cc. of 2 per cent solution) or less of pontocaine as a 0.25 per cent solution with only morphine and atropine in full doses as adjuvent sedation is described.

5) An unselected, consecutive, series of 167 bronchoscopies in adults performed with these techniques using an average of 17.37 mgms. of pontocaine (0.865 cc. of 2 per cent solution) with no complications attributable to pontocaine is reported.

6) This entire series was performed without the use of any barbiturate to counteract the reactions to pontocaine.

7) Pontocaine in 0.25 per cent solution is a safe, effective, and long-lasting surface anesthetic suitable for the procedures of bronchoscopy and bronchography.