Efficacy of a New Psychotropic Drug in Bronchoscopy.

F OR MANY YEARS, BRONCHOSCOPY HAS been performed by most physicians with the use of sedation and a topical anesthetic. more recently there has been a trend toward the use of general anesthesia for this procedure in order to spare the patient an unpleasant experience. However, general anesthesia usually makes the procedure more drastic and more expensive. Many bronchoscopies, morever, are now done for the purpose of treatment rather than diagnosis, and it is important to maintain the cough reflex in order to perform a satisfactory therapeutic aspiration of the bronchial tree. In our experience, such aspiration can be carried out better under topical anesthesia than is pcmible under general anesthetic. It would be advantageous, however, to find some means of reducing or even eliminating the dread and repugnance which many patienu exhibit toward endascopy. The introduction of drugs with the specific action of reducing anxiety and emctional resistance has grea t ly improved methods of premedicating the surgical patient. Many authors have reported chlordiazepoxide (Librium)* as almost ideal for the purpose.'" In bronchoscopy we hope to obtain from a psychotropic d w g three effect5 essential to success: relaxation, cooperation and intact cough reflex. ..\ fourth effect is amnesia about the whole procedure. The patient undergoing bronchoscopy for the fim time needs the assurance that he will probably remember nothing of his experience; and if the procedure must be repeated later, his previous amnesia is likely to insure acceptance. In this important respect, chlordiazepoxide was found wanting, as Brandt and associates' have also noted.