Bronchoscope insertion route and patient comfort during flexible bronchoscopy

Diagnostic flexible bronchoscopy performed in hospitalised and ambulatory patients in a tertiary care academic hospital in Monterrey, Mexico.

To determine the effect of the route of insertion of the bronchoscope (oral or nasal) on patient comfort, vocal cord visualisation, local anaesthetic and sedation requirements and possible complications.

Prospective study carried out in patients aged ⩾ 18 years with an indication for flexible bronchoscopy. The route of insertion was randomly assigned. Symptoms related to the procedure were evaluated using a questionnaire.

Sixty-three patients were included: 32 in the oral insertion group and 31 in the nasal insertion group. There was no statistically significant difference in patient discomfort (1.91 ± 2.95 vs. 2.39 ± 3.56 points on a scale of 1 to 10, P = 0.74) or procedural complications (4 vs. 0 events, P = 0.12) between study groups. Oral insertion was associated with less time to vocal cord visualisation (25.5 ± 156 s vs. 56 ± 61 s, P < 0.01), lower requirement for lidocaine (15 ± 7.50 vs. 16 ± 4 ml, P = 0.01) and fewer insertion failures (0 vs. 6 cases, P < 0.01).

With intravenous sedoanalgesia, route of insertion did not affect patient comfort. However, the oral route was associated with faster vocal cord visualisation, less use of lidocaine and no insertion failure.