Comparison of Two Approaches of Anesthesia in Patients with Preoperative Bronchoscopy_West China Medical Journal

Authors：

 WANXiao-bing , CHENYu-jie , LIBin , LUHai-ying , YANGLing-lin

Department of Respiratory Medicine, the Fourth People's Hospital of Sichuan Province, Chengdu, Sichuan 610016, P. R. China;

Corresponding?author：

Keywords：

Bronchoscopy; Lidocaine; Midazolam; Anesthesia; Inhalation

DOI：

10.7507/1002-0179.20140384

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical effects of nebulized lidocaine anesthesia and anesthesia with lidocaine and midazolam in patients with preoperative bronchoscopy. Methods Totally, 136 inpatients between May 2002 and June 2013 with preoperative bronchoscopy were included in the study. The patients were randomly assigned to experimental group and control group with 68 patients in each. For patients in the experimental group, 8 mL of 2% lidocaine was administered through inhalation anesthesia, followed by 2-3 mg bolus of midazolam, and subsequently 0.5 mg of midazolam was administered every 2 minutes depending on patients' awareness. Patients in the control group accepted lidocaine alone for anesthesia. The clinical efficacy and adverse effects of both the two ways of anesthesia were observed. Results The time of sustained and effective anesthesia was (24.5±2.8) minutes in the experimental group, as compared with (16.8±2.1) minutes in the control group (P<0.01). The average amount of consumption of lidocaine was (12.4±1.3) mL in the experimental group, as compared with (16.8±1.5) mL in the control group (P<0.01). The heart rate at 5 min after operation was (81.5±19.5) beats/min in the experimental group, as compared with (94.6±34.6) beats/min in the control group (P<0.01). The mean pulse oxygen saturation at 5 min after operation was (93.5±3.6)% in the experimental group, as compared with (88.2±13.3)% in the control group (P<0.01). Conclusion Combined application of lidocaine and midazolam before bronchoscopy is simple and feasible for anesthesia, which has higher success rate, lesser side effects and other reactions such as body movement and coughing.

Citation： WANXiao-bing, CHENYu-jie, LIBin, LUHai-ying, YANGLing-lin. Comparison of Two Approaches of Anesthesia in Patients with Preoperative Bronchoscopy. West China Medical Journal, 2014, 29(7): 1252-1254. doi: 10.7507/1002-0179.20140384 Copy

1.	劉長庭. 纖維支氣管鏡診斷治療學[M]. 北京:北京大學醫學出版社, 2003:21-30.
2.	Burns DM, Shure D, Francoz R, et al. The physiologic Consequences of saline lobar lavage in healthy human adults[J]. Am Rev Respir Dis, 1983, 127(6):695-701.
3.	李強. 呼吸內鏡學[M]. 上海:上海科學技術出版社, 2003:75-87.
4.	劉昌起. 纖維支氣管鏡檢查麻醉方法的評價及其并發癥的預防[J]. 中華結核和呼吸雜志, 1994, 17(6):329-330.
5.	許明星. 老年纖維支氣管鏡檢的麻醉[J]. 華西醫學, 2006, 21(2):360.
6.	譚明旗, 劉宏博, 李晶. 霧化吸入利多卡因在纖維支氣管鏡檢查中的應用[J]. 中國內鏡雜志, 2002, 8(12):65-66.
7.	Keane D, Mcnicholas WT. Comparison of nebulized and sprayed topical anaesthesia for fibreoptic bronchoscopy[J]. Eur Respir J, 1992, 5(9):1123-1125.
8.	Macdougall M, Mohan A, Mills J, et al. Randomized comparison of 2 different methods of intrabronchial lidocaine delivery during flexible bronchoscopy:a pilot study[J]. J Bronchology Interv Pulmonol, 2011, 18(2):144-148.
9.	Moustafa MA. Nebulized lidocaine alone or combined with fentanyl as a premedication to general anesthesia in spontaneously breathing pediatric patients undergoing rigid bronchoscopy[J]. Paediatr Anaesth, 2013, 23(5):429-434.
10.	Abbasi S, Mahjobipoor H, Kashefi P, et al. The effect of lidocaine on reducing the tracheal mucosal damage following tracheal intubation[J]. J Res Med Sci, 2013, 18(9):733-738.
11.	Tanaka Y, Nakayama T, Nishimori M, et al. Lidocaine for preventing postoperative sore throat[J]. Cochrane Database Syst Rev, 2009(3):CD004081.
12.	Liao W, Ma G, Su QG, et al. Dexmedetomidine versus midazolam for conscious sedation in postoperative patients undergoing flexible bronchoscopy:a randomized study[J]. J Int Med Res, 2012, 40(4):1371-1380.
13.	Rolo R, Mota PC, Coelho F, et al. Sedation with midazolam in flexible bronchoscopy:a prospective study[J]. Rev Port Pneumol, 2012, 18(5):226-232.
14.	Contoli M, Gnesini G, Artioli D, et al. Midazolam in flexible bronchoscopy premedication:effects on patient-related and procedure-related outcomes[J]. J Bronchology Interv Pulmonol, 2013, 20(3):232-240.
15.	Campo R, Brullet E, Montserrat A, et al. Efficacy of low and standard midazolam doses for gastroscopy. A randomized, doubleblind study[J]. Eur J Gastroenterol Hepatol, 2000, 12(2):187-190.
16.	張景燦, 劉占舉, 周正, 等. 纖維支氣管鏡檢查過程中的心電圖監護[J]. 河南醫學研究, 2005, 14(4):334-336.
17.	陳文彬, 戢朝明, 任治秀, 等. 纖維支氣管鏡檢查過程中的心電圖監護[J]. 實用內科雜志, 1989(6):298-299.
18.	劉芳. 兩種麻醉方法在纖維支氣管鏡患者檢查中的效果比較[J]. 中國實用醫刊, 2013, 40(22):16-17.

1. 劉長庭. 纖維支氣管鏡診斷治療學[M]. 北京:北京大學醫學出版社, 2003:21-30.
2. Burns DM, Shure D, Francoz R, et al. The physiologic Consequences of saline lobar lavage in healthy human adults[J]. Am Rev Respir Dis, 1983, 127(6):695-701.
3. 李強. 呼吸內鏡學[M]. 上海:上海科學技術出版社, 2003:75-87.
4. 劉昌起. 纖維支氣管鏡檢查麻醉方法的評價及其并發癥的預防[J]. 中華結核和呼吸雜志, 1994, 17(6):329-330.
5. 許明星. 老年纖維支氣管鏡檢的麻醉[J]. 華西醫學, 2006, 21(2):360.
6. 譚明旗, 劉宏博, 李晶. 霧化吸入利多卡因在纖維支氣管鏡檢查中的應用[J]. 中國內鏡雜志, 2002, 8(12):65-66.
7. Keane D, Mcnicholas WT. Comparison of nebulized and sprayed topical anaesthesia for fibreoptic bronchoscopy[J]. Eur Respir J, 1992, 5(9):1123-1125.
8. Macdougall M, Mohan A, Mills J, et al. Randomized comparison of 2 different methods of intrabronchial lidocaine delivery during flexible bronchoscopy:a pilot study[J]. J Bronchology Interv Pulmonol, 2011, 18(2):144-148.
9. Moustafa MA. Nebulized lidocaine alone or combined with fentanyl as a premedication to general anesthesia in spontaneously breathing pediatric patients undergoing rigid bronchoscopy[J]. Paediatr Anaesth, 2013, 23(5):429-434.
10. Abbasi S, Mahjobipoor H, Kashefi P, et al. The effect of lidocaine on reducing the tracheal mucosal damage following tracheal intubation[J]. J Res Med Sci, 2013, 18(9):733-738.
11. Tanaka Y, Nakayama T, Nishimori M, et al. Lidocaine for preventing postoperative sore throat[J]. Cochrane Database Syst Rev, 2009(3):CD004081.
12. Liao W, Ma G, Su QG, et al. Dexmedetomidine versus midazolam for conscious sedation in postoperative patients undergoing flexible bronchoscopy:a randomized study[J]. J Int Med Res, 2012, 40(4):1371-1380.
13. Rolo R, Mota PC, Coelho F, et al. Sedation with midazolam in flexible bronchoscopy:a prospective study[J]. Rev Port Pneumol, 2012, 18(5):226-232.
14. Contoli M, Gnesini G, Artioli D, et al. Midazolam in flexible bronchoscopy premedication:effects on patient-related and procedure-related outcomes[J]. J Bronchology Interv Pulmonol, 2013, 20(3):232-240.
15. Campo R, Brullet E, Montserrat A, et al. Efficacy of low and standard midazolam doses for gastroscopy. A randomized, doubleblind study[J]. Eur J Gastroenterol Hepatol, 2000, 12(2):187-190.
16. 張景燦, 劉占舉, 周正, 等. 纖維支氣管鏡檢查過程中的心電圖監護[J]. 河南醫學研究, 2005, 14(4):334-336.
17. 陳文彬, 戢朝明, 任治秀, 等. 纖維支氣管鏡檢查過程中的心電圖監護[J]. 實用內科雜志, 1989(6):298-299.
18. 劉芳. 兩種麻醉方法在纖維支氣管鏡患者檢查中的效果比較[J]. 中國實用醫刊, 2013, 40(22):16-17.

West China Medical Journal

Comparison of Two Approaches of Anesthesia in Patients with Preoperative Bronchoscopy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content