Effectiveness of intrabronchial local anesthesia with a spray catheter and continuous oral suction in reducing cough during bronchoscopy: A prospective study

Background: Coughing and other distress during bronchoscopy are undesirable for both patients and bronchoscopists. The efficacy of local anesthetics administered via aerosol sprays in the airways has been documented; however, the optimal administration method remains unclear. Furthermore, the efficacy of continuous salivary aspiration in reducing cough and other distress has not yet been evaluated.

Methods: Patients scheduled for bronchoscopy were assigned to 1 of 4 groups-group A (intrabronchial local anesthesia using a syringe without continuous oral suction); group B (intrabronchial local anesthesia using a spray catheter without continuous oral suction); group C (intrabronchial local anesthesia using a syringe with continuous oral suction using a saliva ejector); group D (intrabronchial local anesthesia using a spray catheter with continuous oral suction using a saliva ejector). The distress levels of the patients were evaluated using a questionnaire with a visual analog scale, and cough counts were quantified during bronchoscopy. Additionally, we assessed the total amount of lidocaine consumed and changes in vital signs.

Results: Local anesthesia in the airway using a spray catheter did not reduce patient distress; however, it reduced cough frequency (P = 0.03) and lidocaine dosage (P = 0.0004). Continuous suctioning of saliva did not reduce the patients' distress or cough frequency.

Conclusion: The use of a spray catheter rather than a syringe is recommended for administering local anesthesia with lidocaine during bronchoscopy. Conversely, continuous suctioning of saliva is not routinely recommended for all patients.