Subjective Tolerance to Flexible Bronchoscopy

Negrín, Lorenzo Manuel Pérez; Martin, Joan; Fernández, Orlando Acosta; Castilla, J. L. Trujillo; Hernandez, F. Gonzalvo

doi:10.1097/01.lbr.0000011086.62728.bf

Cited by 7 publications

(1 citation statement)

References 17 publications

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“…To the best of our knowledge, this is the first randomized, single-blind, placebo-controlled study on the effect of combination of TEAS preconditioning and midazolam in FB. The discomfort experienced during FB includes cough, nausea, pain, and dyspnea [11]. Cough is an inevitable adverse effect associated with FB; in fact, 25% of patients undergoing FB consider cough as the worst adverse effect of bronchoscopy [1].…”

Section: Discussionmentioning

confidence: 99%

Cough Suppression during Flexible Bronchoscopy Using Transcutaneous Electric Acupoint Stimulation: A Randomized Controlled Study

Zhang

Yang

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Background and Objective. Transcutaneous electric acupoint stimulation (TEAS) is recommended for its sedative and analgesic effects. We sought to evaluate the effect of TEAS on cough suppression during flexible bronchoscopy (FB) and explore the underlying mechanism. Methods. In this single-center, randomized, single-blind, parallel-controlled study, we randomized 100 patients scheduled for FB into two equal groups treated with or without TEAS (TEAS group and control group). Patients in the TEAS group received 30 min of stimulation at the Hegu (LI4), Neiguan (PC6), and Lieque (LU7) points before FB. The control group underwent the same procedure, but without stimulation. The primary outcome was the intraoperative cough score determined by the bronchoscopist. The secondary outcomes were patient-reported discomfort scores and other procedural parameters. Results. Compared with the controls, patients who received TEAS preconditioning had lower cough scores (P=0.0027) and requirement of lidocaine and fentanyl (P < 0.05) and significantly higher postprocedural plasma β-endorphin levels (P=0.0367). There were no intergroup differences in discomfort scores, midazolam dosage, rate of premature termination, oxygen requirement, sedation level, airway assistance, oxygen saturation, lowest oxygen saturation level, heart rate, plasma substance-P levels, and rate of complications after 24 h. The total procedure duration, time for passage of the bronchoscope through the vocal cords, and systolic and diastolic blood pressure levels were less in the TEAS group than in the control group (P=0.033, 0.039 and <0.05, respectively). Conclusion. The combination of midazolam and TEAS was superior to midazolam alone for cough suppression during FB, probably due to increased plasma β-endorphin levels. This trial is registered with ChiCTR1800016612 at chictr.org.cn/index.aspx.

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Section: Discussionmentioning

confidence: 99%