To define which anesthetic method used during flexible bronchoscopy determines better results to facility the procedure, besides to verify which they present minors rates of complications.
Eighty patients were analyzed. They were divided in four groups of twenty patients according to drugs used: 1. 200mg of topical lidocaine (LID group); 2. . 200mg of topical lidocaine plus 2mg/kg of propofol (PPF group); 3. 200mg of topical lidocaine plus 20mcg/kg of alfentanil (ALF group); and 4. . 200mg of topical lidocaine plus 0,5mg/kg of midazolam (MID group). The patients were analyzed following some variables showed during and after the bronchoscopy (cardiac dysrhythmia, hypoxemia, cough, additional necessity, lidocaine intoxication, restlessness, respiratory failure, laryngospasm, hypotension, dizziness, vomiting, conscience level and change of anesthetic method). Each variable was given a score to determine a final component score.
The final component score was 4,6±3,9 to PPF group, 7,9±6,6 to ALF group, 10,0±4,5 to LID group and 11,3±5,8 to MID group (p = 0,001).
The results show the superiority of propofol plus topic lidocaine association use during flexible bronchoscopy when compared with alfentanil, midazolam or lidocaine alone.
The choice of an effective and low morbidity anesthetic method is basic for the success of a flexible bronchoscopy. This study it demonstrated the superiority of the association of propofol and topic lidocaine in the anesthesia for flexible bronchoscopy.
Andre Leite, None.Table 1—
Variables analyzed during the procedure.Component scorePPF n=20ALF n=20LID n=20MID n=20pCardiac dysrhythmia [0 a 4]0,3±0,40,6±0,90,4±0,50,3±0,40,376Hypoxemia [0 a 4]0,7±1,11,1±1,30,5±0,81,3±1,40,117Coughing [0 a 6]1,9±1,6a1,7±1,9a3,4±1,1b3,0±1,8b0,003Additional lidocaine [0 a 4]0,6±0,90,8±1,01,3±1,01,3±1,00,054Lidocaine intoxication [0 a 4]0,0±0,00,0±0,00,0±0,00,0±0,0—Restlessness [0 a 6]0,3±1,0a1,6±1,5b3,3±1,5c1,6±1,9b<0,001Respiratory depression [0 a 6]0,2±0,90,6±1,50,0±0,00,8±1,60,138laryngospasm [0 a 1]0,0±0,00,0±0,00,0±0,00,0±0,0—Hypotension [0 a 4]0,2±0,40,5±0,90,1±0,30,3±0,40,287Dizziness and/or vomiting [0 a 1]0,0±0,00,0±0,00,1±0,30,0±0,00,106Conscience level [0 a 3]0,5±0,9a1,2±0,9b0,0±0,0a1,7±1,2c<0,001Change of the method [0 a 6]0,0±0,00,0±0,00,9±2,20,9±2,20,091
Non-coincident index-letters show significant differences in the Duncan post hoc test. PPF: propofol, ALF: alfentanil, LID: lidocaine, MID: midazolam.