Local anaesthesia for fibreoptic bronchoscopy—whereare we now?

Webb, Justin

doi:10.1016/s0954-6111(08)80067-4

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…Although no major complications were encountered in the present study, the transtracheal route has more potential complications than the other techniques [5]. These include paroxysms of severe coughing, (with concomitant rise of heart rate, blood pressure, intracranial pressure), intralaryngeal bleeding, pain, cellulitis, oesophageal penetration, paratracheal abscess and subcutaneous emphysema.…”

Section: Discussionmentioning

confidence: 58%

“…However they used 4 ml of 2.5% cocaine, a drug which is not available for routine clinical use. In the present study we employed lignocaine which is undoubtedly a safer local anaesthetic than cocaine [5]. The precise deposition of the local anaesthetic viz on the cords and in the trachea would also have a bearing on the efficacy of reflex obtundation obtained.…”

Section: Discussionmentioning

confidence: 99%

“…Prior to endoscopy, while the upper airway is commonly anaesthetized by local lignocaine spray or gel, the modalities of applying local anaesthetic to the larynx and lower respiratory tract include injection via the fiberoptic bronchoscope and transtracheal injection delivery via a nebulizer [5].…”

Section: Introductionmentioning

confidence: 99%

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Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques

Sethi

Tarneja

Madhusudanan³

et al. 2005

Medical Journal Armed Forces India

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques

Sethi

Tarneja

Madhusudanan³

et al. 2005

Medical Journal Armed Forces India

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“…One small randomised study found a decreased cough rate, but similar patient experience, associated with cricothyroid administration (vs spray-as-you-go) 133. A further small randomised study found bronchoscopic conditions, but not patient assessment, were improved for cricothyroid administration compared with nebulised lidocaine 134…”

Section: Premedication Sedation and Topical Anaesthesia For Fbmentioning

confidence: 99%

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

Rand

Blaikley

Booton

et al. 2013

Thorax

683

735

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“…19 Although, in 1990, Webb J. measured serial plasmalidocaine concentrations during a similar protocol fortopical lidocaine nebulizer and reported very low systemicabsorption of topical lidocaine and minimal cardiovasculareffect. 20 Similarly, Langmacket al measured the serum lignocaine levels in 51 asthmatic volunteers undergoing FOB with topical lignocaine. 22 The average total dose used was 600 mg (8.2 mg/kg), which was found to be safe in all patients as assessed by serum lignocaine concentrations.…”

Section: Discussionmentioning

confidence: 99%

Topical Airway Anaesthesia Techniques In Dental Patients With Temporomandibular Joint Ankylosis: A Comparison Between Nebulization Versus Nerve Blocks For Awake Nasal Fiberoptic Intubation

Bansal¹,

Khatri²

2016

IOSR

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Introduction:Awakenasal fiberoptic bronchoscope (FOB) guided intubation is the gold standard of airway management in patients withtemporomandibular joint ankylosis. It is essential to sufficiently anesthetize the upper airway before the performance of awake FOB guided intubation in order to ensure patient comfort and cooperation and maintain haemodynamics. This randomized controlled study was performed to compare two methods of airway anesthesia, namely topical nebulization of local anesthetic and performance of airway blocks. Materials and methods: Consent was obtained from 46 adult patients of temporomandibular joint ankylosis, scheduled for gap arthroplasty. They were enrolled for thisdouble-blind, randomized, prospective clinical trial with two treatment groups -Group N and Group NB, of 23 patients each. Group N received airway anesthesia through jet nebulization of 10 ml of 4% lignocaine and Group NB received airway blocks (bilateral superior laryngeal and transtracheal recurrent laryngeal) each with 2 ml of 2% lignocaine aswell as topicalairway spray with 4% lignocaine. FOB guided nasotracheal intubation was then performed. Hemodynamic variables at baseline and during the procedure, patient recall and comfort-before and after intubation, vocal cord visibility, conditions achieved at endoscopy, coughing/gagging episodes, and postoperative events were noted. Results:The success rate of awakefiberoptic intubation was 100%.The haemodynamic parameters, endoscopic conditions and patient response and comfortwas better with nerve block group than nebulization group. Most of the intubations were carried out in less than 3 minutes, however the time taken in group NB was less than in group N. Vocal cord visibility and ease of intubation were better in patients who received airway blocks and hence the amount of supplemental lignocaine used was less in this group.Conclusion: Both ways of topical anaesthesia of airway nebulisation with lignocaine and nerve block technique are satisfactory. However fiberoptic nasal intubation using nerve block technique provides better intubating conditions, patient satisfaction, haemodynamic stability with minimal complications.

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Local anaesthesia for fibreoptic bronchoscopy—whereare we now?

Cited by 9 publications

References 9 publications

Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques

Local Anaesthesia for Fiberoptic Intubation : A Comparison of Three Techniques

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

Topical Airway Anaesthesia Techniques In Dental Patients With Temporomandibular Joint Ankylosis: A Comparison Between Nebulization Versus Nerve Blocks For Awake Nasal Fiberoptic Intubation

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