Abstract：
BACKGROUND: The SARS-CoV-2 pandemic, pharyngeal anesthesia such as nebulizer or lidocaine pump spray is the risk of droplet transmission to health care workers from coughing due to spraying anesthesia. Absence of pharyngeal anesthesia may induce coughing and reduce patient and operator satisfaction, but the efficacy of pharyngeal anesthesia under sedation is still limited. Therefore we evaluated a prospective, randomized, single-blind trial to evaluate efficacy of pharyngeal anesthesia in patients receiving sedation.
METHODS: We conducted a randomized comparison of pharyngeal anesthesia with or without bronchoalveolar lavage in patients undergoing bronchoscopy at our hospital between March and October 2022. Pharyngeal anesthesia was performed using 8％ lidocaine spray and the operators were blinded to eliminate bias. Two hundred patients were entered into the study and divided into two groups: those who received pharyngeal anesthesia(control group) and did not receive pharyngeal anesthesia(test group). The primary endpoint was the operator\'s satisfaction with the procedure. The secondary endpoints were the patient\'s cough during the examination as perceived by the operator, cough and discomfort experienced by the patient and the dose of analgesic/sedative/lidocaine administered. These scales were scored from 0 to 100.
RESULTS: In primary endpoint, there was no significant difference in the operator-rated procedure satisfaction between the 2 groups. The median for the discomfort score for patients in the control group was tendency higher than in the test group. There were no significant differences in other secondary endpoints.
CONCLUSIONS: Pharyngeal anesthesia may not be recommended for flexible bronchoscopy performed under combined sedation and analgesia.
BACKGROUND: Registration number: UMIN000046975Date of registration: 2022/03/07.
METHODS: We conducted a randomized comparison of pharyngeal anesthesia with or without bronchoalveolar lavage in patients undergoing bronchoscopy at our hospital between March and October 2022. Pharyngeal anesthesia was performed using 8％ lidocaine spray and the operators were blinded to eliminate bias. Two hundred patients were entered into the study and divided into two groups: those who received pharyngeal anesthesia(control group) and did not receive pharyngeal anesthesia(test group). The primary endpoint was the operator\'s satisfaction with the procedure. The secondary endpoints were the patient\'s cough during the examination as perceived by the operator, cough and discomfort experienced by the patient and the dose of analgesic/sedative/lidocaine administered. These scales were scored from 0 to 100.
RESULTS: In primary endpoint, there was no significant difference in the operator-rated procedure satisfaction between the 2 groups. The median for the discomfort score for patients in the control group was tendency higher than in the test group. There were no significant differences in other secondary endpoints.
CONCLUSIONS: Pharyngeal anesthesia may not be recommended for flexible bronchoscopy performed under combined sedation and analgesia.
BACKGROUND: Registration number: UMIN000046975Date of registration: 2022/03/07.
摘要：
背景：SARS-CoV-2大流行，咽部麻醉如喷雾器或利多卡因泵喷雾是由于喷雾麻醉引起的咳嗽而将液滴传播给医护人员的风险。没有咽部麻醉可能会引起咳嗽，降低患者和操作者的满意度，但咽部麻醉在镇静下的疗效仍然有限。因此，我们评估了一个前瞻性的，随机化，单盲试验，以评估接受镇静的患者咽部麻醉的疗效。
方法：我们在2022年3月至10月期间在我院接受支气管镜检查的患者中，对有或没有支气管肺泡灌洗的咽部麻醉进行了随机比较。咽部麻醉使用8％利多卡因喷雾剂进行，操作人员为消除偏倚而盲目。200名患者进入研究，分为两组：接受咽部麻醉的患者（对照组）和未接受咽部麻醉的患者（测试组）。主要终点是操作员对手术的满意度。次要终点是操作者在检查期间感觉到的患者咳嗽，患者的咳嗽和不适以及镇痛药/镇静剂/利多卡因的剂量。这些量表从0到100评分。
结果：在主要终点，两组之间的操作人员评估程序满意度无显著差异.对照组患者的不适评分中位数有高于测试组的趋势。其他次要终点无显著差异。
结论：咽部麻醉可能不推荐用于联合镇静和镇痛的柔性支气管镜检查。
背景：注册号：UMIN000046975注册日期：2022/03/07。
方法：我们在2022年3月至10月期间在我院接受支气管镜检查的患者中，对有或没有支气管肺泡灌洗的咽部麻醉进行了随机比较。咽部麻醉使用8％利多卡因喷雾剂进行，操作人员为消除偏倚而盲目。200名患者进入研究，分为两组：接受咽部麻醉的患者（对照组）和未接受咽部麻醉的患者（测试组）。主要终点是操作员对手术的满意度。次要终点是操作者在检查期间感觉到的患者咳嗽，患者的咳嗽和不适以及镇痛药/镇静剂/利多卡因的剂量。这些量表从0到100评分。
结果：在主要终点，两组之间的操作人员评估程序满意度无显著差异.对照组患者的不适评分中位数有高于测试组的趋势。其他次要终点无显著差异。
结论：咽部麻醉可能不推荐用于联合镇静和镇痛的柔性支气管镜检查。
背景：注册号：UMIN000046975注册日期：2022/03/07。
