Spray nozzle for topical anaesthesia during flexible bronchoscopy: a randomised controlled trial

Area of Science:

• Pulmonology
• Anesthesiology
• Medical Devices

Background:

• Topical airway anesthesia is crucial for non-sedation flexible bronchoscopy (FB).
• The effectiveness of spray nozzle (SN) delivery of lidocaine compared to conventional methods is uncertain.

Purpose of the Study:

• To compare the efficacy of SN lidocaine delivery versus classical spray (CS) for topical airway anesthesia during non-sedation FB.
• To evaluate cough rates and patient/operator subjective experiences.

Main Methods:

• Randomized controlled trial comparing SN group to CS group.
• Primary outcome: cough rate (coughs per minute).
• Secondary outcomes: patient and operator visual analogue scale ratings for discomfort, tolerance, and willingness to repeat procedure.

Main Results:

• The SN group showed a significantly lower median cough rate (4.5 vs. 7.1 counts/min; p=0.021).
• Patients in the SN group reported less oropharyngeal discomfort, better tolerance, and higher willingness for repeat FB.
• Operators noted lower patient discomfort and cough scores in the SN group.

Conclusions:

• Spray nozzle delivery of lidocaine offers superior topical airway anesthesia during non-sedation FB.
• This method enhances patient comfort and procedural tolerance.
• SN delivery is a promising alternative to conventional spray methods for FB anesthesia.