Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1990 Jun;45(6):474–477. doi: 10.1136/thx.45.6.474

Local anaesthesia for fibreoptic bronchoscopy: transcricoid injection or the "spray as you go" technique?

A R Webb 1, S S Fernando 1, H R Dalton 1, J E Arrowsmith 1, M A Woodhead 1, A R Cummin 1
PMCID: PMC462533  PMID: 2392794

Abstract

Local anaesthesia for fibreoptic bronchoscopy should be given by a safe technique that is not unpleasant to the patient and should provide acceptable conditions for the bronchoscopist. Single injection transcricoid local anaesthesia was compared with the "spray as you go" technique in patients having day case fibreoptic bronchoscopy. Patients were randomised to receive either 100 mg lignocaine by a single cricothyroid puncture or 240 mg lignocaine instilled through the bronchoscope under direct vision. Further doses were given by the operator to both groups as required. The 30 patients receiving transcricoid lignocaine coughed less (3.56 (SD 3.1) coughs/min) than the 32 patients receiving lignocaine through the bronchoscope (5.89 (4.8)/min) despite receiving a lower total dose of lignocaine (322 (25.9) v 451 (20.9) mg). Cricothyroid puncture was not associated with any complications and was not unpleasant for the patients.

Full text

PDF
474

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aitken R. C. Measurement of feelings using visual analogue scales. Proc R Soc Med. 1969 Oct;62(10):989–993. doi: 10.1177/003591576906201005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Credle W. F., Jr, Smiddy J. F., Elliott R. C. Complications of fiberoptic bronchoscopy. Am Rev Respir Dis. 1974 Jan;109(1):67–72. doi: 10.1164/arrd.1974.109.1.67. [DOI] [PubMed] [Google Scholar]
  3. Fry W. A. Techniques of topical anesthesia for bronchoscopy. Chest. 1978 May;73(5 Suppl):694–696. doi: 10.1378/chest.73.5.694. [DOI] [PubMed] [Google Scholar]
  4. Jones D. A., McBurney A., Stanley P. J., Tovey C., Ward J. W. Plasma concentrations of lignocaine and its metabolites during fibreoptic bronchoscopy. Br J Anaesth. 1982 Aug;54(8):853–857. doi: 10.1093/bja/54.8.853. [DOI] [PubMed] [Google Scholar]
  5. Korttila K., Tarkkanen J., Tarkkanen L. Comparison of laryngotracheal and ultrasonic nebulizer administration of lidocaine in local anaesthesia for bronchoscopy. Acta Anaesthesiol Scand. 1981 Apr;25(2):161–165. doi: 10.1111/j.1399-6576.1981.tb01628.x. [DOI] [PubMed] [Google Scholar]
  6. Macdonald J. B. Fibreoptic bronchoscopy today: a review of 255 cases. Br Med J. 1975 Sep 27;3(5986):753–755. doi: 10.1136/bmj.3.5986.753. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Macfarlane J. T., Ward M. J. Transtracheal injection of saline in the investigation of pneumonia. Br Med J (Clin Res Ed) 1984 Mar 31;288(6422):974–975. doi: 10.1136/bmj.288.6422.974-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Patterson J. R., Blaschke T. F., Hunt K. K., Meffin P. J. Lidocaine blood concentrations during fiberoptic bronchoscopy. Am Rev Respir Dis. 1975 Jul;112(1):53–57. doi: 10.1164/arrd.1975.112.1.53. [DOI] [PubMed] [Google Scholar]
  9. Perry L. B. Topical anesthesia for bronchoscopy. Chest. 1978 May;73(5 Suppl):691–693. doi: 10.1378/chest.73.5_supplement.691. [DOI] [PubMed] [Google Scholar]
  10. Webb A. R., Doherty J. F., Chester M. R., Cummin A. R., Woodhead M. A., Nanson E. M., Flack S. T., Millard F. J. Sedation for fibreoptic bronchoscopy: comparison of alfentanil with papaveretum and diazepam. Respir Med. 1989 May;83(3):213–217. doi: 10.1016/s0954-6111(89)80034-4. [DOI] [PubMed] [Google Scholar]
  11. Webb A. R., Woodhead M. A., Dalton H. R., Grigg J. A., Millard F. J. Topical nasal anaesthesia for fibreoptic bronchoscopy: patients' preference for lignocaine gel. Thorax. 1989 Aug;44(8):674–675. doi: 10.1136/thx.44.8.674. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES