Assessment of patient satisfaction and lidocaine requirement during flexible bronchoscopy without sedation

Bronchoscopy is usually performed under sedation to improve patient comfort and willingness to accept a repeat procedure. Bronchoscopy with a low dose of sedation does not necessarily improve patient comfort, and overt sedation may be dangerous for those with preexisting lung diseases.

The aim of this study was to evaluate the visual analogue scale for cough, pain, nausea, choking sensation, and overall discomfort level during flexible bronchoscopy without sedation. Acceptance of repeat bronchoscopy and requirement of lidocaine during the procedure were also evaluated.

We evaluated 70 consecutive patients who underwent flexible bronchoscopy without sedation at our hospital. None received any premedication, and lidocaine was used as a topical anesthetic during the procedure. After the bronchoscopy, a questionnaire containing the visual analogue scale for cough, pain, nausea, choking sensation, and overall discomfort during the procedure was administered. Total requirement of lidocaine and patients' willingness to return for repeat bronchoscopy were recorded.

Visual analogue scale ratings of cough, pain, nausea, and choking sensation during the study procedure were mild to moderate in 38.6% to 94.3% of the patients. The mean dose of lidocaine used during the bronchoscopy was 7.44±2.09 mg/kg. The visual analogue scale of any symptom score had no correlation with the amount of lidocaine used (P>0.05). Only 27.1% would definitely accept repeat bronchoscopy, if required.

Bronchoscopy without sedation is quite a well-tolerated procedure, and the required amount of lidocaine during the procedure does not exceed the recommended dose. However, acceptance of repeat bronchoscopy is low.