The Comparative Study Of Lidocaine Anesthetic Effect Of Different Administration Route In Tracheoscopy

Objective:To compare three commonly used methods of local anesthesia in tracheoscopy.Methods:This study selected adult patients who have fiberoptic bronchoscopy for the first time in respiratory endoscopy room of Shandong Provincial Hospital from August2013to October2013. In this study they were randomly divided into three groups, respectively given lidocaine mouth spary (SPR), nebulization method (NEB), endobronchoscopic instillation (BI). We subjectively analyze the local anesthesia effect thouguh visual analog scale (VAS) and severity scale, and we do the sound waveform analysis, an objective record of cough, dyspnea hold times in the process of the operation to assess the effect of local anesthesia. Using statistical software to measure data, p<0.05considered statistically significant.Results:(1) Patients’ VAS scores showed a clear preference for the nebulization method (p<0.01). Patients also reported that the NEB method produced less cough during intubation of the larynx and inspection of the airways (p<0.01). The NEB method was also preferred by the bronchoscopists (p<0.001); they reported less cough and easier tracheal intubation.(2) The mean cough count was significantly lower for the NEB group(p<0.001). Patients’ and bronchoscopists’ VAS showed significant correlation with cough (patients p<0.05, bronchoscopists p<0.01). Subjective and objective measurement shows that NEB method produced excellent local anesthesia for fiberopticbronchoscopy, there were no extra complications.(3) Subgroup analysis showed that gender, BMI has no relationship with the local anesthetic effect; anesthesia in elderly patients is better than the young adult patients, may be appropriate to reduce the amount of local anesthetic drugs; patients whose smoking index are more than400have poor anesthetic effect.Conclusions:(1) Nebulized2%lidocaine is the method preferred by both patients and bronchoscopists(2) Effect of preoperative anesthesia has nothing to do with the patients’sex, body mass index; we may reduce the dosage of anesthetic drugs in older patients (>60years old); we may moderate increase the amount of anesthetic drugs in people whose smoking index is high (>400).