Randomized Comparison of 2 Different Methods of Intrabronchial Lidocaine Delivery During Flexible Bronchoscopy

Abstract

Adequate anesthesia during bronchoscopy is essential for patient comfort and tolerance, and for achieving a good sample yield. The Enk device was designed for use during anesthesia for awake intubations. The objective of this study was to compare patient tolerability and frequency of cough during flexible bronchoscopy according to the method of administration of local anesthetic. Patients were randomized to receive topical lidocaine either nebulized through an Enk device or with conventional injection through the working channel of the bronchoscope. All patients, physicians, and the assisting nurse completed a questionnaire that included items on tolerability, ease of procedure, frequency of cough, etc. The response was marked on a 10-cm-long visual analog scale, with a higher score indicating better outcome. Fifty patients were divided into 2 groups of 25 patients each. The mean ± standard deviation duration of procedure was no different in the Enk group than in the syringe group (12.8 ± 7.5 and 10.8 ± 6.9 min, respectively). There was no statistically significant difference between the 2 groups in the scores of each of the questions. The Enk device showed a nonsignificant trend toward greater ease of procedure for the operator with no difference in the frequency of cough. For the patients, there was no significant difference. A further investigation through comparison with other methods, such as transtracheal installation, over a larger population may yield more significant results. This trial was registered with the Local Research Ethics Committee and with International Standard Randomised Controlled Trial Number.