Nebulized dexmedetomidine-lidocaine inhalation as a premedication for flexible bronchoscopy: a randomized trial.

Nebulized dexmedetomidine-lidocaine inhalation as a premedication for flexible bronchoscopy: a randomized trial. J Thorac Dis. 2019 Nov;11(11):4663-4670 Authors: Gu W, Xu M, Lu H, Huang Q, Wu J Abstract Background: Dexmedetomidine plus opioid infusion after topical anaesthesia with nebulized lidocaine for cough suppression is a commonly used method for flexible bronchoscopy. Recently, the use of dexmedetomidine as an additive to local anaesthetics has been reported to have several advantages over conventional intravenous administration. However, there are no data regarding the use of nebulized dexmedetomidine-lidocaine for topical anaesthesia as a premedication for flexible bronchoscopy. Therefore, this study compared the tolerability and safety of nebulized dexmedetomidine with that of conventional intravenous administration in patients undergoing bronchoscopy with moderate sedation. Methods: Sixty patients requiring flexible bronchoscopy were randomly assigned to three groups: (I) nebulized dexmedetomidine + lidocaine, n=20; (II) intravenous dexmedetomidine + nebulized lidocaine, n=20; and (III) nebulized lidocaine alone (no dexmedetomidine), n=20. The patients' coughing scores were assessed and graded. Our primary hypothesis was that nebulized dexmedetomidine-lidocaine could reduce the incidence of moderate to severe coughing. The secondary endpoints were the rates of glottis closure, complete jaw relaxation and limb movement during the procedure; ...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

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Conclusion: Various therapeutic bronchoscopic interventions, including combined modalities, provide rapid and sustained improvements in symptoms, respiratory status, exercise capacity, and quality of life in malignant CAO and have a good safety profile.
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Original Investigations Source Type: research
ConclusionThe 1% tetracaine hydrochloride injection pure liquid aerosol inhalation combined with oral administration of dyclonine hydrochloride mucilage as upper airway anesthesia is effective and safe for bronchoscopy. This method of local anesthesia is worthy of clinical application.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusion: This technique is relatively easy to use and less dependent on equipment with small outer diameter in the selective pulmonary lobe isolation in infants and small children.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusions: In this cohort, 8% of children undergoing elective FB-BAL experienced side effects severe enough to delay discharge resulting in overnight admission or require the child to re-attend hospital after discharge. These risks should be discussed with children and parents when consenting for FB-BAL.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric bronchology Source Type: research
ConclusionThe 1% tetracaine hydrochloride injection pure liquid aerosol inhalation combined with oral administration of dyclonine hydrochloride mucilage as upper airway anesthesia is effective and safe for bronchoscopy. This method of local anesthesia is worthy of clinical application.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
Publication date: Available online 10 October 2019Source: The Annals of Thoracic SurgeryAuthor(s): Yasuto Sakaguchi, Kazuya Matsumoto, Kensuke Nishioka, Norishige Iizuka, Yutaka Hirayama, Aya Kitaoka, Kazuya Tanimura, Ken-ichi Takahashi, Motokazu KatoAbstractTracheobronchopathia osteochondroplastica is a rare benign condition where multiple cartilaginous or bony submucosal nodules project into the trachea or bronchi. A 71-year-old man complained of cough for 3 months. Computed tomography scanning revealed a calcified tracheal tumor near the tracheal bifurcation. Pulmonary function testing indicated airflow limitation, and ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract Tracheobronchopathia osteochondroplastica is a rare benign condition where multiple cartilaginous or bony submucosal nodules project into the trachea or bronchi. A 71-year-old man complained of cough for 3 months. Computed tomography scanning revealed a calcified tracheal tumor near the tracheal bifurcation. Pulmonary function testing indicated airflow limitation, and bronchoscopic examination confirmed a solitary rigid tumor. Bronchoscopic resection was performed under general anesthesia, and the tumor was detached by cauterizing its stem with high-frequency coagulation. The tumor was pathologically indi...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Abstract BACKGROUND AND AIM: The optimal mode of delivering topical anesthesia during flexible bronchoscopy remains unknown. Herein, we compare the efficacy and safety of nebulized lignocaine, lignocaine oropharyngeal spray, or their combination. METHODS: Consecutive subjects were randomized 1:1:1 to receive nebulized lignocaine (2.5 mL of 4% solution, group A), oropharyngeal spray (10 actuations of 10% lignocaine, group B), or nebulization (2.5 mL, 4% lignocaine) and two actuations of 10% lignocaine spray (group C). The primary outcome was the subject-rated severity of cough, using the visual analogue scale ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Rationale: Rigid bronchoscopy under general anesthesia enables performing diagnostic and/or therapeutic procedures in the tracheobronchial tree. As most patients undergoing rigid bronchoscopy have moderate to severe respiratory disease or central airway obstruction, the operators often face the risk of hypoxemia when inserting the rigid bronchoscope into the patients’ airway. Applying high flow nasal cannula (HFNC) oxygen therapy before the insertion of the bronchoscope allows to maintain high fractional inspired oxygen (FiO2) and thus leading to maximizing apnea time before desaturation. Patient concerns and diag...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: Administration of nebulized lignocaine in addition to pharyngeal lignocaine spray, during no-sedation bronchoscopy, increases the cumulative lignocaine dose without improved procedural comfort. Additional nebulized lignocaine during bronchoscopy is not recommended.
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
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