The clinical question hinges on whether the use of antisialogogic agents such as atropine or glycopyrrolate is necessary prior to adult bronchoscopy to increase patient tolerance of the procedure or improve visualization of the airway anatomy. The use of these drugs adds cost to each procedure and, in some cases, can actually result in unnecessary, untoward side effects. It has been known for years that midazolam can, by itself or in combination with other sedative-analgesic agents, have some minor antisialogogic properties.5,6 The study by Apiliogullari et al3 further bolsters the argument that if there is indeed an antisialogogic effect from the use of midazolam, then the use of other secretion-reducing agents is clearly not needed. A clinically significant result in the initial randomized trials would have meant that the use of antisialogogic drugs provides a clear benefit to the bronchoscopist and patient in terms of the ability to inspect the airway and improves the overall comfort of the procedure above and beyond that provided without their use. That was not determined in those studies, even after randomization of > 1,000 patients between the two trials. Although Apiliogullari and colleagues3 should be congratulated for their efforts in quantitating salivary flow rates, that result does not alter the fact that the use of antisialogogues is unnecessary prior to routine adult bronchoscopy and does not ultimately affect the measured clinical endpoints, as outlined in the original randomized trials.