Pulmonary Disease Clinical Trial
Official title:
Transcricoid Injection Versus Spray as You go Method for Local Anaesthesia During Flexible Bronchoscopy: A Randomised Controlled Trial
Flexible bronchoscopy is one of the most widely performed procedures for diagnosis of various
bronchopulmonary diseases. Most patients tolerate the procedure well although cough is often
reported as a distressing symptom. It is likely that the acceptance of bronchoscopy would be
significantly improved with control of cough. Use of sedation during bronchoscopy has been
reported to improve procedure tolerance. However, awake(no sedation) bronchoscopy is
routinely performed at many centres including ours.
Topical lignocaine is administered during bronchoscopy for local anaesthesia. There is
limited literature on the efficacy of transtracheal/transcricoid injection versus spray as
you go method for lignocaine delivery to the airways during bronchoscopy. This study would
help to determine the procedure comfort for the patient while using the
transtracheal/transcricoid method vs the spray as you go method.
For all patients meeting the inclusion criteria, the demographic profile including age, sex,
weight, smoking history and the type of procedures performed during bronchoscopy shall be
recorded. A written informed consent will be obtained from all participants. The patients who
undergo flexible bronchoscopy would be randomised in a one is to one ratio either to
transcricoid or spray as you go group. Prior to the bronchoscopy blood pressure, pulse rate,
respiratory rate and pulse oximetry saturation will be recorded at the baseline Patients in
both the groups shall be prepared in a similar fashion except for the initial route of
lignocaine delivery.
During the procedure, 1.5 ml aliquots of 2% lignocaine solution will be delivered through the
bronchoscope when using spray-as-you go technique. Patients in the transcricoid group shall
initially receive 5 ml of 2% lignocaine solution instilled transtracheally along with two
baseline 1.5 cc bronchial spray aliquots of lignocaine, and additional aliquots of 2%
lignocaine using the spray as you go method. The total lignocaine dose during the procedure
will be recorded. The patients would be monitored for any adverse effects throughout the
procedure. The bronchoscopist doing the procedure will be provided 2 VAS charts to mark the
severity of cough and overall procedure satisfaction. Cough count shall be noted.
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