title: Bronchoscope insertion route and patient comfort during flexible bronchoscopy.
abstract: METHODS
  Diagnostic flexible bronchoscopy performed in hospitalised and ambulatory patients in a tertiary care academic hospital in Monterrey, Mexico.
  
  
  OBJECTIVE
  To determine the effect of the route of insertion of the bronchoscope (oral or nasal) on patient comfort, vocal cord visualisation, local anaesthetic and sedation requirements and possible complications.
  
  
  METHODS
  Prospective study carried out in patients aged ⩾ 18 years with an indication for flexible bronchoscopy. The route of insertion was randomly assigned. Symptoms related to the procedure were evaluated using a questionnaire.
  
  
  RESULTS
  Sixty-three patients were included: 32 in the oral insertion group and 31 in the nasal insertion group. There was no statistically significant difference in patient discomfort (1.91 ± 2.95 vs. 2.39 ± 3.56 points on a scale of 1 to 10, P = 0.74) or procedural complications (4 vs. 0 events, P = 0.12) between study groups. Oral insertion was associated with less time to vocal cord visualisation (25.5 ± 156 s vs. 56 ± 61 s, P < 0.01), lower requirement for lidocaine (15 ± 7.50 vs. 16 ± 4 ml, P = 0.01) and fewer insertion failures (0 vs. 6 cases, P < 0.01).
  
  
  CONCLUSIONS
  With intravenous sedoanalgesia, route of insertion did not affect patient comfort. However, the oral route was associated with faster vocal cord visualisation, less use of lidocaine and no insertion failure.
authors: Servicio de Neumología, Hospital Universitario 'Dr José E González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors: J E
authors: JE
authors: González Aguirre
authors: Servicio de Neumología, Hospital Universitario 'Dr José E González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors: U
authors: U
authors: Chavarría Martínez
authors: Servicio de Neumología, Hospital Universitario 'Dr José E González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors: D
authors: D
authors: Rodríguez Mier
authors: Servicio de Neumología, Hospital Universitario 'Dr José E González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors: M
authors: M
authors: Acosta Moreno
authors: Servicio de Neumología, Hospital Universitario 'Dr José E González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
authors: R
authors: R
authors: Mercado Longoria
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000494:pharmacology; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000494:pharmacology; D016014:Linear Models; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine