PURPOSE: We performed a prospective, randomized, single-blind(bronchoscopist only), trial to compare the effectiveness of the translaryngeal spray anesthesia and the oral nebulizer inhalation anesthesia during flexible bronchoscopy without sedation.
METHODS: 100 patients undergoing diagnostic flexible bronchoscopy were randomized to receive 3 mL of 4% lidocaine (120 mg) either in the translaryngeal spray anesthesia (S group) or in the oral nebulizer inhalation anesthesia (N group). 8 patients who had severe complications such as hemorrhage during bronchoscopy were excluded. Supplemental lidocaine doses during bronchoscopy and bronchoscopists were recorded for each patient. After the procedure, both bronchoscopists and patients charted their perception of cough on a 10-cm visual analog scale (VAS). Similarly, patients recorded their discomfort related to the procedure on a 10-cm VAS.
RESULTS: Subjects were 92 patients (67 male and 25 female) divided into 2 groups of equal numbers and aged 66.5 years old in the median, of whom 81 purpose of abnormal shadow transbroncheal biopsy and 11 others. Outcome parameters, mean [± SD] cough scores for physicians and patients, discomfort score for patients, and supplemental lidocaine doses were 3.2±2.2/3.7±2.7 cm (p=0.48), 4.5±2.7/4.8±2.1 cm (p=0.57), 3.7±2.9/4.4±2.4 cm (p=0.11), and 5.7±2.0/5.9±1.8 ml (p=0.97) respectively in each groups (S/N).
CONCLUSION: As the pretreatment for flexible bronchoscopy without sedation S group and N group did not have the statistically significant difference.
CLINICAL IMPLICATIONS: The oral nebulizer inhalation anesthesia during flexible bronchoscopy without sedation is effective.
DISCLOSURE: Mitsuhiro Sumitani, No Financial Disclosure Information; No Product/Research Disclosure Information