Outpatient Fiberoptic Bronchoscopies

To the Editor.  —Ackart et al, in the January Archives (1983;143:30-31), presented impressive data on 1,428 outpatient fiberoptic bronchoscopies (FOB), documenting the safety of this diagnostic procedure when using topical anesthesia in selected patients whose conditions do not require transbronchial biopsies or fluoroscopic control. At about the same time that the first 318 of these patients were reviewed at Portsmouth, Va,¹ I presented my own experience with 380 patients examined in an outpatient setting.² My own patients differed from the Portsmouth patients in that parenteral premedication was always given (including atropine sulfate, pentobarbitol sodium, and/or morphine sulfate) and that 41 transbronchial biopsies were performed. This experience, together with our subsequent 500 + bronchoscopies performed without significant morbidity (unpublished data), establishes the low morbidity of the procedure, irrespective of the use of premedication and the performance of transbronchial biopsy. Pertinent data from my original study is briefly reviewed herein, since