Topical application of epinephrine during bronchoscopy in barbiturate-halothane-anaesthesia and its influence on...

Since the introduction of halothane as an anaesthetic there have been several reports about cardiac arrhythmias during application of epinephrine in combination with halothane. This complication was also reported when epinephrine was used as local haemostyptic. We describe the effect of topical epinephrine upon cardiac action during bronchoscopy in barbiturate-halothane-anaesthesia. 21 patients with an average age of 66.4 years underwent bronchoscopy mainly because of suspect bronchial carcinoma, they were monitored by lead I ECG and blood gas analysis was carried out repeatedly. Immediately following biopsies, sponses with epinephrine solution 1:1000 were applied to the bronchial mucosa - the average epinephrine dose of these sponges was 0.12 mgs as calculated before by weighting. During this procedure we could not observe significant cardiac arrhythmias following epinephrine application. We conclude this to be the result of limited dosage and maintenance of adequate ventilation and oxygenation. Thus, epinephrine can be used as a local haemostyptic during bronchoscopy in halothane anaesthesia without significant risk when the above described precautions are observed.