Catheter Spray of Lidocaine : a Randomized Study of Topical Anesthesia for Flexible Bronchoscopy
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- Tachihara Motoko
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Ishida Takashi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Fukuhara Naoko
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Inokoshi Yayoi
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Fukuhara Atsuro
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Saito Kazue
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Ishii Taeko
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Kanazawa Kenya
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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- Katsuura Yutaka
- Department of Pulmonary Medicine, Saiseikai Fukushima General Hospital
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- Munakata Mitsuru
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
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Abstract
Background. Topical anesthesia is recommended for patients undergoing bronchoscopy. The spray catheter is a device to administer lidocaine in the airway. We performed a prospective, randomized trial to evaluate optimal lidocaine delivery using the spray catheter. Methods. We randomized 88 patients undergoing bronchoscopy without sedation into three groups (catheter A, B, and syringe C, with 23, 34 and 31 patients, respectively). Catheter A patients received two kinds of pre-bronchoscopic lidocaine administration, followed by lidocaine with the spray catheter. Catheter B patients received lidocaine with one pre-bronchoscopic anesthesia, followed by the catheter anesthesia. Syringe C patients received conventional syringe injection after two pre-bronchoscopic anesthesia. Major outcome measures included the frequency of cough, dose and serum concentration of lidocaine, changes in vital signs, and assessment of patient suffering. Results. The lidocaine dose during bronchoscopy in the syringe C group was 312.0±76.0mg (mean±SD), which was significantly higher than that in the catheter A (48.0±6.0mg) and B (50.0±12.0mg, p<0.01) groups. Serum lidocaine concentration in catheter A (1.1±0.3mg/l) and B (1.0±0.1mg/l) groups was significantly lower than that in the syringe C group (2.2±1.2mg/l, p<0.01). There were no statistically significant differences between the three groups in terms of coughing episodes, hemodynamic changes and discomfort questionnaire scores. Conclusion. Safe and efficacious topical anesthesia for awake bronchoscopy can be achieved by catheter spray, with a low dosage and plasma concentration of lidocaine.
Journal
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- The Journal of the Japan Society for Respiratory Endoscopy
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The Journal of the Japan Society for Respiratory Endoscopy 36 (4), 359-363, 2014
The Japan Society for Respiratory Endoscopy
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Details
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- CRID
- 1390282679731350400
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- NII Article ID
- 110009833215
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- ISSN
- 21860149
- 02872137
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- Text Lang
- en
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- Data Source
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- JaLC
- CiNii Articles
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- Abstract License Flag
- Disallowed