Iatrogenic superior vena cava syndrome. A complication of internal jugular venous catheters.

CHEST, 70: 4, OCTOBER, 1976 if a 1-percent solution is adequate. We use 5 ml of a 4percent solution of lidocaine (for a total of 200 mg) to anesthetize the larynx and tracheobronchial tree. We have now performed over 4,500 examinations with the fiberoptic bronchoscope using the oral route of intubation and have encountered no episodes of serious laryngospasm.2 More importantly, we premedicate any asthmatic patient, whether symptomatic or asymptomatic, with a drip infusion of aminophylline, giving 100 to 300 mg before and during the procedure and more during the postbronchoscopic period if any suggestion of bronchospasm appears. We can also leave the oral airway in place if it appears as though the patient may be in some distress. Having the intravenous needle in place for the drip infusion of aminophylline also gives us a quick route for administering a steroid bolus, should it be needed.