The efficacy of 1% versus 2% lignocaine Solution administered by “working Channel” method for topical anesthesia in Flexible bronchoscopy without Administration of concurrent lignocaine Nebulization – one year rct

Abstract

INTRODUCTION Flexible bronchoscopy is essential in respiratory medicine field for the diagnosis and management of respiratory conditions by direct airway visualization, enabling sample collection and many therapeutic interventions. Effective topical anesthesia is crucial for patient comfort and procedural safety as it is a day care procedure. Lignocaine, commonly used due to its efficacy and safety, is administered via nebulization, "spray-as-you-go," or direct application through the bronchoscope's working channel. While nebulization may cause uneven anesthetic distribution, the working channel method offers controlled application. This study compares the efficacy and safety of 1% versus 2% lignocaine solution administered via the working channel without nebulization, aiming to determine if a lower concentration can provide effective anesthesia with fewer risks and safer hemodynamic outcomes. OBJECTIVES · The primary objective of this study is to compare the hemodynamic effects of 1% versus 2% lignocaine used as a topical anesthetic during flexible bronchoscopy. · Secondary objectives include evaluating patient comfort using the Visual Analog Scale (VAS), assessing operator satisfaction through cough severity score and cough count, determining the necessity for additional anesthesia methods, calculating the cumulative lignocaine doses, and identifying any procedural side effects of lignocaine. viii · Additionally, the study aims to assess the impact of the topical anesthetic on bacterial cultures obtained during the procedure