[How bothersome is fiber bronchoscopy under local anesthesia?]

All the 79 (7.4%) complications of 1066 fiberoptic bronchoscopies performed under standardized topical anaesthesia in in- and outpatients were analyzed retrospectively. With the 4.9 mm bronchoscope the transnasal route was possible in all cases, and with the 6.0 mm bronchoscope in 92%. There were no deaths and no major complications, with the exception of one tension-pneumothorax, one pneumonia, one pulmonary edema and one 500 ml hemorrhage. The most frequent complications were minor hemorrhages (4.1%) which occurred mainly after biopsies and were rarely recognized by the patients. laryngospasms (1.5%) and bronchospasms (1.4%). The rate of complications was higher in patients with a FEV1 of less than 60% predicted (p = 0.02) and in patients with a pO2 below 50 mm Hg (p = 0.06). We recommend the administration of oxygen during fiberoptic bronchoscopy. Fever within 36 hours after bronchoscopy was observed in 12% and subsided without antibiotic therapy. In the light of these risks, patients should be informed prior to the procedure of the possible occurrence of shortness of breath, hemorrhage and fever.