Pre-operative nasal probe tests with adrenaline and lidocaine ease insertion during flexible bronchoscopy and reduce post-operative bleeding:a randomized controlled trial  

作　　者：Wenjun Zhu Yuchen Zhang Jingyu Shi Xiaoqin Wang Renjiao Li Jia Liu Ping Li Dan Liu Fengming Luo 

机构地区：[1]Department of Pulmonary and Critical Care Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China [2]Laboratory of Pulmonary Immunology and Infammation,Frontiers Science Center for Disease-Related Molecular Network,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China

出　　处：《Chinese Medical Journal》2022年第15期1808-1813,共6页中华医学杂志（英文版）

基　　金：National Natural Science Foundation of China(NSFC No.81770072);The"1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYJC18021);Chengdu Science and Technology Bureau(No.2018-CY02-00064-GX)。

摘　　要：Background:Nasal insertion is the preferred method for non-intubated patients in flexible bronchoscopy;however,the relatively narrow nasal cavity results in difficulties related to bronchoscope insertion.This study aimed to investigate whether pre-operative nasal probe tests could reduce the time to pass the glottis,improve the first-pass success rate and patients’tolerance,and reduce postoperative bleeding.Methods:This three-arm prospective randomized controlled trial was conducted in a tertiary hospital between May and October 2020.Three hundred patients requiring diagnosis and treatment using flexible bronchoscopy were randomly allocated to three groups:control group,simple cotton bud detection group(CD group),and adrenaline+lidocaine detection group(AD group).The primary outcome was the time to pass the glottis.Secondary outcomes included the first-pass success rate,the patients’tolerance scores,and post-operative bleeding.One-way analysis of variance,Kruskal-WallisH test,Chi-squared test,Fisher’s exact test,and Bonferroni’s multiple comparison tests were used in this study.Results:In total,189 men and 111 women were enrolled in this study,with a mean age of 55.72±12.86 years.The insertion time was significantly shorter in the AD group than in the control group(18.00 s[12.00–26.50 s]vs.24.00 s[14.50–45.50 s],P=0.005).Both the AD(99%vs.83%,χ2=15.62,P<0.001)and CD groups(94%vs.83%,χ2=5.94,P=0.015)had a significantly higher first-pass success rate than the control group.Compared with the control group,post-operative bleeding(1%vs.13%,χ2=11.06,P<0.001)was significantly lower in the AD group.However,no significant difference was found in the patients’tolerance scores.Conclusions:Pre-operative nasal cavity probe tests especially with adrenaline and lidocaine during flexible bronchoscopy can significantly reduce the time to pass the glottis,improve the first-pass success rate,and reduce post-operative nasal bleeding.Pre-operative nasal probe tests are recommended as a time-saving procedure for pati

关 键 词：Complications Flexible bronchoscopy Nasal cavity-glottis time Nasal probe test 

分 类 号：R562.2[医药卫生—呼吸系统]