Prospective cohort study of topical versus general anaesthesia for flexible bronchoscopy

Topical anaesthesia (TA) and general anaesthesia (GA) are performed for flexible bronchoscopy (FB) worldwide. However, few studies have compared the two anaesthesia methods in terms of perioperative discomforts.

648 patients undergoing FB were recruited in Shanghai Pulmonary Hospital, a specialised medical centre in China, from January 2019 to December 2019. The patients underwent FB under TA or GA. The TA group received 1% lidocaine by nasal route, and the GA group received total intravenous anaesthesia. The level of perioperative discomfort and patient satisfaction were assessed. The investigators were blind to the group allocation.

Finally, 239 patients received TA and 182 patients received GA. The basic demographic properties were comparable between two groups. There were no significant differences in terms of sore throat, 61.5% in TA group vs 57.1% in GA group. However, there was a significant difference in terms of postoperative nausea and vomiting (34.3% in TA group vs 56.6% in GA group), and dizziness (37.7% in TA group vs 78% in GA group). There was a significant difference in terms of total complication scores (17.2 ± 5.1 in TA group vs 7.7 ± 4.3 in GA group) and satisfaction degree of patients (2.6 ± 1.1 in TA group vs 4.3 ± 0.8 in GA group).

Compared with TA, GA significantly reduced the total complication scores of perioperative discomforts and improved the satisfaction score of patients for FB.

This clinical trial was registered with www.chictr.org.cn (ChiCTR1800019971).