Lidocaine Concentrations in Bronchoscopic Specimens

Avaliação do risco de contaminação por bactérias, no paciente submetido à broncoscopia, após o reprocessamento do broncoscópio

“…A dose utilizada, em geral, foi de 5 a 8ml (41,42) . Ultrapassada a laringe, o aparelho era deslizado para as vias aéreas inferiores, alternando avanço do aparelho e instilação de 1ml de lidocaína líquida a 2%, evitando exceder a dose total de 400mg.…”

Fibre‐optic bronchoscopy in adults: a position paper of The Thoracic Society of Australia and New Zealand

“…Lignocaine, an amide local anaesthetic agent, is the drug of choice because of its relatively quick onset of action, short duration of action and decreased toxicity compared with other agents. It may be administered by nebulization, via a spray to the nasal cavity, nasopharynx and oropharynx, or via injection through the bronchoscope in a ‘spray as you go’ technique to the larynx and tracheobronchial tree 25,28,29 . If the nasal route is used for bronchoscopy, lignocaine can be applied as a gel formulation, which can be used to lubricate the bronchoscope in its passage through the nasal cavity 25 .…”

“…The total recommended dose without adrenaline is 4–5 mg/kg 31 . Up to this concentration topical lignocaine generally is safe, hypersensitivity reactions rare, clinically significant bronchoconstriction does not occur and toxic plasma levels are not reached 25 . A total topically administered dose of greater than 512 mg has been shown to have the potential of causing toxic serum concentrations 32 .…”

“…Percutaneous oxygen saturation, heart and respiratory rate and blood pressure should be monitored. Because topical lignocaine has a duration of airway anaesthesia of approximately 40 min, patients should remain nil orally for at least 1 h or until pharyngeal sensation has been restored 25 . A medical practitioner should be readily available at all times to attend to the patient, particularly if the patient is obtunded or has respiratory depression.…”

“…The application of topical local anaesthetic to the airways is effective in inducing airway anaesthesia (grade C). 25 Recent studies have shown local anaesthetic agents to have antimicrobial properties, although not all bacteria are susceptible. 26,27 Their use may therefore result in false-negative results of microbiological tests carried out on bronchoscopic specimens (grade C).…”