Lung India

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 37  |  Issue : 5  |  Page : 384--388

Comparison of spray catheter with “spray-as-you-go” technique for airway anesthesia during flexible bronchoscopy – A randomized trial


Kavitha Venkatnarayan1, Uma Devaraj1, Uma Maheswari Krishnaswamy1, Priya Ramachandran1, Tinku Thomas2, George DíSouza1 
1 Department of Pulmonary Medicine, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
2 Department of Biostatistics, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Kavitha Venkatnarayan
3rd Floor, Oncology Block, St. John's Medical College, Sarjapur Road, Bengaluru - 560 034, Karnataka
India

Background: Administration of local airway anesthesia is the principal determinant of procedural comfort during flexible bronchoscopy. However, the ideal method of administration is still unknown. In this study, we compared lignocaine administration using a spray catheter (SC) with “spray-as-you-go” technique. Methods: Patients undergoing bronchoscopy were randomized to receive airway anesthesia with 2% lignocaine through the SC (SC group) or “spray-as-you-go” technique through the working channel (WC group). The primary outcome parameter was cough count, and the secondary outcome parameters compared were need for sedation, operator-rated procedural satisfaction and cough, and patient-rated comfort on a Visual Analog Scale (VAS). Results: One hundred and thirty patients were randomized with comparable baseline parameters. The median (interquartile range [IQR]) cough count was 28 (19, 37) in the WC group and 15 (9, 23) in the SC group (P < 0.001). Requirement for sedation was lower in the SC group (5 vs. 18; P = 0.003). The mean (standard deviation [SD]) VAS score for operator-rated satisfaction was 66.5 (16.8) in the WC group and 80.6 (14.2) in the SC group; P < 0.001. The median (IQR) VAS score for operator-rated cough was 35 (23, 44) in the WC group and 18 (11, 28) in the SC group; P < 0.001. However, there was no difference in the patient-rated comfort VAS (mean [SD] of 66.4 [14.5] in the WC group and 69.9 [13.0] in the SC group; P = 0.07). Conclusion: Lignocaine instillation using the SC during bronchoscopy reduced cough, need for sedation, and improved operator satisfaction.


How to cite this article:
Venkatnarayan K, Devaraj U, Krishnaswamy UM, Ramachandran P, Thomas T, DíSouza G. Comparison of spray catheter with “spray-as-you-go” technique for airway anesthesia during flexible bronchoscopy – A randomized trial.Lung India 2020;37:384-388


How to cite this URL:
Venkatnarayan K, Devaraj U, Krishnaswamy UM, Ramachandran P, Thomas T, DíSouza G. Comparison of spray catheter with “spray-as-you-go” technique for airway anesthesia during flexible bronchoscopy – A randomized trial. Lung India [serial online] 2020 [cited 2020 Sep 29 ];37:384-388
Available from: http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=5;spage=384;epage=388;aulast=Venkatnarayan;type=0