Wisborg T
Ugeskr Laeger. 1989 Jul 3;151(27):1740-4.
Bronchoscopy with the fibre bronchoscope under local analgesia influences circulatory and pulmonary function, depending partly on the form of premedication employed, anticholinergic preparations, the local analgesic and the form of application. Physiological and pharmacological knowledge is available on which a rational choice of the method of examination may be based. In order to reduce untoward sequelae of the examination, the following are recommended: avoidance of sedative premedication, which appears to be unnecessary, administration of supplementary oxygen during and for at least two hours after the examination (special care is required in cases of chronic hypercapnia) and employment of anticholinergic preparations, particularly in asthmatic patients. Nevertheless, slight degrees of bronchoconstriction may be anticipated during and after the examination. Examination via an endotracheal tube is warned against in patients with respiratory difficulties. There is much to recommend the choice of lidocaine as the routine analgesic and this is administered in the form of inhalation from an atomizer. On the basis of absorption investigations, the dosage may probably be raised to approximately 7 mg/kg. Patients with cardiac and liver disease have, however, reduced distribution volumes and clearance.
局部麻醉下使用纤维支气管镜进行支气管镜检查会影响循环和肺功能，部分取决于所采用的术前用药形式、抗胆碱能制剂、局部麻醉剂及应用方式。现已有生理和药理学知识，可据此合理选择检查方法。为减少检查的不良后果，建议如下：避免使用似乎不必要的镇静性术前用药；检查期间及检查后至少两小时给予补充氧气（慢性高碳酸血症患者需特别注意）；使用抗胆碱能制剂，尤其是哮喘患者。然而，检查期间及检查后可能会出现轻度支气管收缩。有呼吸困难的患者应避免通过气管内插管进行检查。利多卡因作为常规麻醉剂很值得选用，可通过雾化器以吸入形式给药。根据吸收研究，剂量可能可提高至约7毫克/千克。然而，患有心脏和肝脏疾病的患者分布容积和清除率会降低。
