title: Oral insertion of a flexible bronchoscope is associated with less discomfort than nasal insertion for Korean patients.
abstract: OBJECTIVE
  The route of bronchoscope insertion varies between centres, without a firm rationale based on well-designed studies. We therefore compared nasal and oral insertion of a flexible bronchoscope and evaluated efficacy and patient satisfaction.
  
  
  METHODS
  Prospective randomised study of patients who underwent flexible bronchoscopy from May to September 2003 and who were randomly assigned to nasal and oral insertion approaches.
  
  
  RESULTS
  Clinical characteristics, factors related to the procedure and patient satisfaction were analysed. In total, 307 patients were randomly assigned to the nasal (n = 158) or oral insertion groups (n = 149). No difference in baseline characteristics was identified between the groups. Insertion by the oral route was associated with a smaller amount of lidocaine use during the procedure (P = 0.04) and less frequent insertion site bleeding (P = 0.005). Patients assigned to oral insertion reported less discomfort during anaesthesia (P = 0.01) and scope insertion (P < 0.001), as well as less dyspnoea (P = 0.04) and coughing (P = 0.03).
  
  
  CONCLUSIONS
  Oral insertion of a flexible bronchoscope was associated with less discomfort for patients than nasal insertion, although the route of insertion had no significant effect on outcome.
authors.affiliation: Department of Internal Medicine and Lung Institute, Division of Pulmonary and Critical Care Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: C M
authors.initials: CM
authors.lastname: Choi
authors.forename: H I
authors.initials: HI
authors.lastname: Yoon
authors.forename: S M
authors.initials: SM
authors.lastname: Lee
authors.forename: C-G
authors.initials: CG
authors.lastname: Yoo
authors.forename: Y W
authors.initials: YW
authors.lastname: Kim
authors.forename: S K
authors.initials: SK
authors.lastname: Han
authors.forename: Y-S
authors.initials: YS
authors.lastname: Shim
authors.forename: J-J
authors.initials: JJ
authors.lastname: Yim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D008171:Lung Diseases / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009666:Nose; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome