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Nebulization versus standard application for topical anaesthesia during flexible bronchoscopy under moderate sedation – a randomized controlled trial
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Nebulization versus standard application for topical anaesthesia during flexible bronchoscopy under moderate sedation – a randomized controlled trial
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Nebulization versus standard application for topical anaesthesia during flexible bronchoscopy under moderate sedation – a randomized controlled trial
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Journal Article
Nebulization versus standard application for topical anaesthesia during flexible bronchoscopy under moderate sedation – a randomized controlled trial
2018
Overview
Background
Endobronchial administration of lidocaine is commonly used for cough suppression during diagnostic bronchoscopy. Recently, nebulization of lidocaine during bronchoscopies under deep sedation with fiberoptic intubation using a distinct spray catheter has been shown to have several advantages over conventional lidocaine administration via syringe. However, there are no data about this approach in bronchoscopies performed under moderate sedation. Therefore, this study compared the tolerability and safety of nebulized lidocaine with conventional lidocaine administration via syringe in patients undergoing bronchoscopy with moderate sedation.
Methods
Patients requiring diagnostic bronchoscopy were randomly assigned to receive topical lidocaine either via syringe or via nebulizer. Endpoints were consumption of lidocaine and sedative drugs, as well as patient tolerance and safety.
Results
Sixty patients were included in the study (
n
= 30 in each group). Patients required lower doses of endobronchial lidocaine when given via nebulizer versus syringe (164.7 ± 20.8 mg vs. 250.4 ± 42.38 mg;
p
< 0.0001) whereas no differences in the dosage of sedative drugs were observed between the two groups (all
p
> 0.05). Patients in the nebulizer group had higher mean oxygen saturation (96.19 ± 2.45% vs. 94.21 ± 3.02%;
p
= 0.0072) and a lower complication rate (0.3 ± 0.79 vs. 1.17 ± 1.62 per procedure;
p
= 0.0121) compared with those in the syringe group.
Conclusions
Endobronchial lidocaine administration via nebulizer was well-tolerated during bronchoscopies under moderate sedation and was associated with reduced lidocaine consumption, a lower complication rate and better oxygenation compared with lidocaine administration via syringe.
Trial registration
The study was registered with clinicaltrials.gov (
NCT02262442
; 13
th
October 2014).
Publisher
BioMed Central,BioMed Central Ltd,Nature Publishing Group,BMC
Subject
/ Aged
/ Analysis
/ Anesthetics, Local - administration & dosage
/ Bronchoscopy - instrumentation
/ Conscious Sedation - instrumentation
/ Conscious Sedation - standards
/ Cough
/ Female
/ Humans
/ Lidocaine - administration & dosage
/ Male
/ Medicine
/ Nebulizers and Vaporizers - standards
/ Oxygen Consumption - drug effects
/ Oxygen Consumption - physiology
/ Patients
/ Pneumology/Respiratory System
/ Safety
/ Studies
/ Thorax
