Abstract
Two different methods of topical lidocaine anesthesia for bronchoscopic examinations were tried and compared with current methods. One hundred and two cases were randomly divided into following four groups ; A : 7ml of 4% lidocaine was sprayed with a Jackson's laryngotracheal sprayer (30 cases), B : 7ml of 2% lidocaine was sprayed with the sprayer, followed by intratracheal instillation of 2ml of 2% lidocaine (21 cases), C : (spray tube method) After pharyngeal anesthesia was obtained by 0.6ml of 8% lidocaine, 5ml of 4% lidocaine was sprayed through the spray tube (PW-5L, Olympus, Tokyo) via the bronchoscope (22 cases), D : (laryngotracheal anesthesia kit method) After pharyngeal anesthesia, the laryngotracheal anesthesia kit (LTA 360, Abbott) was intubated, through which 5ml of 4% lidocaine was sprayed (29 cases). Supplemental lidocaine was given by way of the working channel of the bronchoscope (2% lidocaine 2ml each time) when coughing developed. Significant differences were observed in the dosage of lidocaine employed for bronchoscopy among four groups, i. e., A : 374±43mg, B : 322±20mg, C : 226±25mg, D : 210±15mg. The best state of anesthesia was achieved in group D. No significant difference was seen in serum lidocaine concentration among the groups. No significant relationship was observed between serum lidocaine concentration and dosage of lidocaine administered, or between serum lidocaine concentration and state of anesthesia. Difficult intubation and laryngotracheal injury were the complications observed in group D. The spray tube method and the laryngotracheal anesthesia kit method are more appraisable than current methods.
