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Prospective cohort study of topical versus general anaesthesia for flexible bronchoscopy
  1. Di Feng1,
  2. Ye Gu2,
  3. Li Liu3,
  4. Lei Shen4,
  5. Hong Shi1
  1. 1Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
  2. 2Department of Endoscopy, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
  3. 3Department of Anesthesiology, Shanghai Jiaotong University First People's Hospital, Shanghai, China
  4. 4Department of Thoracic ICU, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
  1. Correspondence to Dr Hong Shi, Department of anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China; 13651958255{at}139.com; Dr Lei Shen, Department of Thoracic ICU, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China; sh_leisen{at}126.com

Abstract

Background 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.

Methods 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.

Results 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).

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

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

  • bronchoscopy
  • adult anaesthesia

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Not applicable.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Not applicable.

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Footnotes

  • DF and YG contributed equally.

  • Contributors HS, LS and YG designed this research. DF and LL collected research data. YG analysed the data. All authors contributed to the edition of the manuscript and approved the final submission. HS is the guarantor of the work.

  • Funding This study was by Shanghai Special Programme for Research on Ageing and Women and Children’s Health (to HS, No. 2020YJZX0136), TalentProgramme of Shanghai Pulmonary Hospital (to HS, No. fkgg1809; to DF, No. fkxr1909) and Shanghai Pujiang Programme (to LS, No. 2020PJD053).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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