title: Topical nasal anaesthesia for fibreoptic bronchoscopy: lignocaine spray or gel?
abstract: Lignocaine spray for anaesthetising the nasal mucosa for fibreoptic bronchoscopy often causes discomfort to the patient. We compared two techniques of applying nasal topical anaesthesia using either lignocaine spray (group A: 25 patients) or gel (group B: 30 patients) to assess patients' tolerance to the procedure. Both groups received 100 mg of lignocaine in the nostril, 40-50 mg to oropharynx, 120 mg to vocal cords and 40-100 mg to trachea and bronchi. Throat anaesthesia was the most common unpleasant part experienced by both groups of patients (34.5%), followed by examination of bronchi (30.6%) and nasal anaesthesia (21.8%). Significantly more patients in group A experienced discomfort or pain during nasal anaesthesia as compared to group B (p < 0.001). Patients' tolerance to the bronchoscopy was similar in both groups and the examination was performed satisfactorily in all patients. Thus, lignocaine gel is a simple technique, effective and less irritating as compared to lignocaine spray for topical nasal anaesthesia.
authors.affiliation: Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
authors.forename: B M
authors.initials: BM
authors.lastname: Zainudin
authors.forename: M H
authors.initials: MH
authors.lastname: Rafia
authors.forename: A W
authors.initials: AW
authors.lastname: Sufarlan
mesh_terms: D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D005782:Gels; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009666:Nose; D009960:Oropharynx; D017060:Patient Satisfaction; D010614:Pharynx
chemical_list: D000336:Aerosols; D005782:Gels; D008012:Lidocaine