Randomized-controlled Trial to Study the Equivalence of 1% Versus 2% Lignocaine in Cough Suppression and Satisfaction During Bronchoscopy

Hasmoni, Mohd Hadzri; Rani, Mohammed Fauzi Abdul; Harun, Roslan; Manap, Roslina Abdul; Tajudin, Nor Adina Ahmad; Anshar, Fauzi Md

doi:10.1097/lbr.0b013e31816b653c

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…A randomised spray-as-you-go study, comparing the same volume of 1% and 2% lidocaine (delivered to the larynx and tracheobronchial tree), found no difference in subjective and objective measures of cough suppression 136. Another randomised study compared similar volumes of 1%, 1.5% and 2% lidocaine trickled onto the back of the patient's tongue, which was allowed to be aspirated into the larynx 137.…”

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

679

735

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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

679

735

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“…Lidocaine has theoretical safety benefits over other local anaesthetic agents due to a favourable cardiovascular and systemic toxicity risk profile ; this is the most commonly used local anaesthetic agent for ATI. Following airway topicalisation, clinical evidence of toxicity or levels exceeding toxic plasma concentrations have been shown with lidocaine doses of 6.0–9.3 mg.kg −1 lean body weight . The dose of topical lidocaine should not exceed 9 mg.kg −1 lean body weight (Grade C) .…”

Section: Airway Topicalisationmentioning

confidence: 99%

Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

et al. 2019

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Summary Awake tracheal intubation has a high success rate and a favourable safety profile but is underused in cases of anticipated difficult airway management. These guidelines are a comprehensive document to support decision making, preparation and practical performance of awake tracheal intubation. We performed a systematic review of the literature seeking all of the available evidence for each element of awake tracheal intubation in order to make recommendations. In the absence of high‐quality evidence, expert consensus and a Delphi study were used to formulate recommendations. We highlight key areas of awake tracheal intubation in which specific recommendations were made, which included: indications; procedural setup; checklists; oxygenation; airway topicalisation; sedation; verification of tracheal tube position; complications; management of unsuccessful awake tracheal intubation; post‐tracheal intubation management; consent; and training. We recognise that there are a range of techniques and regimens that may be effective and one such example technique is included. Breaking down the key practical elements of awake tracheal intubation into sedation, topicalisation, oxygenation and performance might help practitioners to plan, perform and address complications. These guidelines aim to support clinical practice and help lower the threshold for performing awake tracheal intubation when indicated.

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“…The findings of this study are similar to those in flexible bronchoscopy, thereby demonstrating that airway anesthesia responses during EBUS-TBNA are like those in flexible bronchoscopy and a lower concentration of lignocaine (1%) using spray-as-you-go method is indeed efficacious in this setting also. [ 3 8 9 10 11 ]…”

Section: Discussionmentioning

confidence: 99%

1% versus 2% lignocaine for airway anesthesia in endobronchial ultrasound-guided transbronchial needle aspiration: A pilot, double-blind, randomized controlled trial

et al. 2018

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Background and Objectives:No previous study has compared different concentrations of lignocaine for topical anesthesia during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). In this pilot study, we compared 1% versus 2% lignocaine for topical airway anesthesia during EBUS-TBNA.Methods:In this double-blind, randomized trial, subjects were randomized to receive either 1% or 2% lignocaine for “spray-as-you-go” administration. All received combined moderate intravenous sedation (midazolam and fentanyl). Ten percent pharyngeal lignocaine spray (two sprays) and nebulized lignocaine (2.5 ml of 4% solution) were administered to all subjects. Administration of additional lignocaine was allowed at operator's discretion. The primary endpoints were operator-rated overall procedural satisfaction and cough, each assessed on visual analog scale (VAS), while the secondary outcomes included patient-rated faces pain scale scores, cumulative lignocaine dose, number of subjects receiving lignocaine >8.2 mg/kg, doses of midazolam/fentanyl between groups, and adverse events during procedure.Results:The mean (standard deviation [SD]) VAS scores for operator-rated procedure satisfaction were 64.2 (25.6) and 68.7 (23.7) in 1% and 2% group, respectively (P = 0.35). The median (interquartile range) VAS scores for operator-rated cough were 48.4 (23.9–69.9) in 1% group and 38.7 (18.6–69.5) in 2% group (P = 0.24). The mean [SD] cumulative lignocaine received in the 2% lignocaine group (248.6 [29.1] mg) was significantly greater than in 1% lignocaine group (178.5 [14.6] mg) (P < 0.01).Conclusion:One percent lignocaine is equally efficacious as 2% lignocaine for topical anesthesia during EBUS-TBNA, at a significantly lower cumulative lignocaine dose.

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Randomized-controlled Trial to Study the Equivalence of 1% Versus 2% Lignocaine in Cough Suppression and Satisfaction During Bronchoscopy

Cited by 9 publications

References 19 publications

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

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

Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

1% versus 2% lignocaine for airway anesthesia in endobronchial ultrasound-guided transbronchial needle aspiration: A pilot, double-blind, randomized controlled trial

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