Comparison of spray catheter with "spray-as-you-go" technique for airway anesthesia during flexible bronchoscopy - A randomized trial.
Anesthesia
bronchoscopy
lignocaine
spray catheter
Journal
Lung India : official organ of Indian Chest Society
ISSN: 0970-2113
Titre abrégé: Lung India
Pays: India
ID NLM: 8405380
Informations de publication
Date de publication:
Historique:
entrez:
5
9
2020
pubmed:
5
9
2020
medline:
5
9
2020
Statut:
ppublish
Résumé
Administration of local airway anesthesia is the principal determinant of procedural comfort during flexible bronchoscopy. However, the ideal method of administration is still unknown. In this study, we compared lignocaine administration using a spray catheter (SC) with "spray-as-you-go" technique. Patients undergoing bronchoscopy were randomized to receive airway anesthesia with 2% lignocaine through the SC (SC group) or "spray-as-you-go" technique through the working channel (WC group). The primary outcome parameter was cough count, and the secondary outcome parameters compared were need for sedation, operator-rated procedural satisfaction and cough, and patient-rated comfort on a Visual Analog Scale (VAS). One hundred and thirty patients were randomized with comparable baseline parameters. The median (interquartile range [IQR]) cough count was 28 (19, 37) in the WC group and 15 (9, 23) in the SC group (P < 0.001). Requirement for sedation was lower in the SC group (5 vs. 18; P = 0.003). The mean (standard deviation [SD]) VAS score for operator-rated satisfaction was 66.5 (16.8) in the WC group and 80.6 (14.2) in the SC group; P < 0.001. The median (IQR) VAS score for operator-rated cough was 35 (23, 44) in the WC group and 18 (11, 28) in the SC group; P < 0.001. However, there was no difference in the patient-rated comfort VAS (mean [SD] of 66.4 [14.5] in the WC group and 69.9 [13.0] in the SC group; P = 0.07). Lignocaine instillation using the SC during bronchoscopy reduced cough, need for sedation, and improved operator satisfaction.
Sections du résumé
BACKGROUND
BACKGROUND
Administration of local airway anesthesia is the principal determinant of procedural comfort during flexible bronchoscopy. However, the ideal method of administration is still unknown. In this study, we compared lignocaine administration using a spray catheter (SC) with "spray-as-you-go" technique.
METHODS
METHODS
Patients undergoing bronchoscopy were randomized to receive airway anesthesia with 2% lignocaine through the SC (SC group) or "spray-as-you-go" technique through the working channel (WC group). The primary outcome parameter was cough count, and the secondary outcome parameters compared were need for sedation, operator-rated procedural satisfaction and cough, and patient-rated comfort on a Visual Analog Scale (VAS).
RESULTS
RESULTS
One hundred and thirty patients were randomized with comparable baseline parameters. The median (interquartile range [IQR]) cough count was 28 (19, 37) in the WC group and 15 (9, 23) in the SC group (P < 0.001). Requirement for sedation was lower in the SC group (5 vs. 18; P = 0.003). The mean (standard deviation [SD]) VAS score for operator-rated satisfaction was 66.5 (16.8) in the WC group and 80.6 (14.2) in the SC group; P < 0.001. The median (IQR) VAS score for operator-rated cough was 35 (23, 44) in the WC group and 18 (11, 28) in the SC group; P < 0.001. However, there was no difference in the patient-rated comfort VAS (mean [SD] of 66.4 [14.5] in the WC group and 69.9 [13.0] in the SC group; P = 0.07).
CONCLUSION
CONCLUSIONS
Lignocaine instillation using the SC during bronchoscopy reduced cough, need for sedation, and improved operator satisfaction.
Identifiants
pubmed: 32883896
pii: LungIndia_2020_37_5_384_293985
doi: 10.4103/lungindia.lungindia_528_19
pmc: PMC7857367
doi:
Types de publication
Journal Article
Langues
eng
Pagination
384-388Déclaration de conflit d'intérêts
None
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