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- Title
Pilot randomized study comparing two techniques of airway anaesthesia during curvilinear probe endobronchial ultrasound bronchoscopy (CP-EBUS).
- Authors
Lee, Hans J.; Haas, Andrew R.; Sterman, Daniel H.; Solly, Randy; Vachani, Anil; Gillespie, Colin T.
- Abstract
This study evaluates two different techniques for topically anaesthetizing the airway with lidocaine during curvilinear probe endobronchial ultrasound bronchoscopy (CP-EBUS): standard injection through the working channel and spray catheter application. This was a randomized, non-blinded, single-centre pilot study. Patients with plans for CP-EBUS under moderate sedation were enrolled. All patients received nebulized lidocaine followed by posterior oropharyngeal lidocaine via atomizer and a cotton ball swab using McGill forceps. Patients were then randomly assigned to lidocaine administration using spray catheter instillation or direct application through the working channel. Lidocaine was administered in a uniform fashion by a single investigator throughout the study. The primary end-point was the number of significant coughing episodes in the first 30 min of bronchoscopy. Other end-points included lidocaine and intravenous sedation medication dosage; severe coughing session; and number of transbronchial needle aspirations. Forty patients were included in the study: 20 patients in each group. The median numbers of coughing episodes in the first 30 min were 1 (spray catheter group) and 2 (standard injection group) ( P < 0.004). Six patients in the standard installation group experienced severe coughing sessions, while there was none in the spray catheter group ( P = 0.02). There were no statistical differences between the groups in the dosage of lidocaine or intravenous sedation medications used. There were a greater number of transbronchial needle aspirations performed in the spray catheter group ( P = 0.008). Lidocaine delivery via the spray catheter reduced the number of significant coughing episodes compared with standard working channel injection during CP-EBUS. Larger studies are needed to confirm these exploratory findings. We compared two techniques for anaesthetizing the airway during curvilinear endobronchial ultrasound bronchoscopy: lidocaine injection through the working channel and spray catheter aerosolization. A prospective randomized study was performed under moderate sedation with coughing as the primary end-point. This study offers an additional insight to optimize bronchoscopy under moderate sedation.
- Subjects
LIDOCAINE; ANESTHESIA; BRONCHOSCOPY; COUGH; MUCOUS membranes
- Publication
Respirology, 2011, Vol 16, Issue 1, p102
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/j.1440-1843.2010.01861.x