Flexible bronchoscopy is one of the most widely performed procedures for diagnosis of various bronchopulmonary diseases. Most patients tolerate the procedure well although cough is often reported as a distressing symptom. It is likely that the acceptance of bronchoscopy would be significantly improved with control of cough. Topical lignocaine is administered during bronchoscopy for local anaesthesia. There is uncertainty regarding the adequate dose of lignocaine sprays for pharyngeal anaesthesia during flexible bronchoscopy. This study would help to determine the optimal dose of lignocaine sprays for pharyngeal anaesthesia during flexible bronchoscopy.
For all patients meeting the inclusion criteria, the demographic profile including age, sex, weight and the type of procedures performed during bronchoscopy shall be recorded. A written informed consent will be obtained from all participants. Enrolled patients will be randomized to receive either 5 or 10 sprays of 10% lignocaine to the pharynx. This will be followed by the standard topical anesthesia procedure followed in our institution involving 5ml of 2% lignocaine gel into the nostril. Transnasal flexible bronchoscopy will be performed with additional 1% lignocaine administered as "spray as you go" method. This will be given as 2 ml aliquots- with similar volume in both groups as baseline. Procedure shall be performed with administration of sedation using Midazolam and Fentanyl if required. Primary outcome will be assessed by noting the operator rated overall procedure satisfaction as a VAS scale score.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
QUADRUPLE
Enrollment
300
5 sprays of 10% lignocaine
10 sprays of 10% lignocaine
AIIMS
New Delhi, India
RECRUITINGAIIMS Rishikesh
Rishikesh, India
RECRUITINGOperator rated overall procedure satisfaction
Visual Analogue Scale score (VAS) between 0 to 100
Time frame: At study completion at approximately 4 months
Operator rated cough
Visual Analogue score (VAS) between 0 to 100
Time frame: At study completion at approximately 4 months
Time from bronchoscope introduction to reaching the vocal cords
Time in seconds
Time frame: At study completion at approximately 4 months
Patient willingness to return for repeat bronchoscopy
Proportion of patients willing for repeat bronchoscopy in each group
Time frame: At study completion at approximately 4 months
Cumulative lignocaine dose
Total dose of lignocaine in milligram (mg)
Time frame: At study completion at approximately 4 months
Complications
Proportion of patients with complications in each group
Time frame: At study completion at approximately 4 months
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