OBJECTIVE： To compare anesthesia effects of 3 anesthesia methods， to investigate anesthesia improvement method for bronch fiber oscope. METHODS： 315 patients undergoing bronch fiber oscope were randomly divided into group A （106 cases）， group B （104 cases） and group C （105 cases）. Group A was treated with traditional bronch fiber oscope lidocaine atomization local anesthesia， group B was treated with modified bronch fiber oscope pethidine combined with lidocaine atomization local anesthesia and group C was treated with three-limb tube connected with laryngeal mask and target-controlled propofol and remifentanil general anesthesia. SaO2， SBP， DBP， heart rate， breathing rate， excellent anesthesia rate， compliance rate， the rate of bodymovement and choking， pain recalling rate were compared among 3 groups before and during examination， and ADR was observed. RESULTS： Compared with before examination， SaO2 of group A was decreased significantly during examination， with statistical significance （P＜0.05）； that of group B and C had no obvious change before and during examination. Blood pressure， heart rate and breathing rate of 3 groups had no obvious change before and during examination. The excellent anesthesia rate and compliance rate of group A were significantly lower than those of group B and C， but the rate of bodymovement cough and pain recalling rate were significantly higher than group B and C， with statistical significantly （P＜0.05）. The excellent anesthesia rate and compliance rate of group B were significantly lower than those of group C， but the rate of bodymovement cough and pain recalling rate were significantly higher than group C， with statistical significance （P＜0.05）. No ADR was found in 3 groups. CONCLUSIONS： Modified bronchoscope atomization local anesthesia and modified painless bronchoscope are better than traditional bronch fiber oscope atomization local anesthesia in anesthesia effect， safety， degree of comfort and acceptability. Modified bronchoscope atomization local anesthesia was best but most expensive， so these methods can be chosen according to patient’s condition.