COMPARISON OF THE EFFICACY OF TOTAL LARYNGEAL ANESTHESIA AND SIMPLE LOCAL ANESTHESIA DURING AWAKE FIBEROPTIC BRONCHOSCOPY
Keywords:Awake bronchoscopy, Fiberoptic, Reasoner Scale, Sedation, Topical Anesthesia, Total Laryngeal Anesthesia
Objective: To compare the efficacy of total laryngeal anesthesia and simple local anesthesia during awake fiberoptic bronchoscopy.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Pulmonology, Combined Military Hospital Lahore, from Jan to Jul 2020.
Methodology: A total of 70 patients, who were undergoing fiberoptic bronchoscopy were divided into two groups. Group-I patients were given topical anesthesia with 2% Lignocaine while group-II patients, in addition to topical Lignocaine, had 2% Lignocaine injected into bilateral internal laryngeal nerves for total laryngeal anesthesia. Assessment of efficacy of anesthesia was evaluated by Reasoner scale.
Results: In group-I, 26 (74.28%) patients showed mild or moderate cough and gagging during stage-1. Fifteen (42.85%) patients showed moderate cough and gagging that interfered with the procedure during stage-2 and 19 (54.28%) patients showed mild cough or gagging that did not interfere with the procedure in stage-3. In group-II, 17 (48.57%) patients exhibited mild cough or gagging during stage-1. Sixteen (45.71%) exhibited mild cough or gagging that did not interfere with the procedure during stage-2 with all the patients showing either no cough or mild cough and gagging that did not interfere with the procedure during stage-3. More patients of group-II 32 (91.42%) agreed to a repeat test if required medically as compared to group-I 28 (80%).
Conclusion: Patients undergoing fiberoptic bronchoscopy who underwent total laryngeal anesthesia and sedation, in addition to topical anesthesia experienced less cough and gagging than those receiving only local anesthesia.