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The goal of this randomized control trial is to evaluate the effectiveness and safety of using a spray nozzle, compared to the conventional method, for topical anesthesia by the spray-as-you-go technique in reducing cough frequency, improving cough, discomfort, tolerance, satisfaction, reducing the dosage of lidocaine consumption of patients during flexible bronchoscopy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group S | Experimental | Group S patients will receive topical lidocaine anesthesia via the spray nozzle by the spray as-you-go technique during flexible bronchoscopy. |
|
| Group C | No Intervention | Group C patients will receive topical lidocaine anesthesia with the conventional method by the spray as-you-go technique during flexible bronchoscopy. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Washing Pipe With a Spray Nozzle | Device | Administration of topical airway anesthesia via a washing pipe with a spray nozzle using the spray-as-you-go technique |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cough rate | The bronchoscopy procedure will be audio-taped throughout and cough counting will be recorded by an investigator blinded to the patient information and grouping. The cough rate will be calculated as total cough counts divided by procedure time in minute. | Through the duration of the bronchoscopy exam, an average of 30 min |
| Measure | Description | Time Frame |
|---|---|---|
| Procedure time | The duration (minute) of the bronchoscopic procedure | Through the duration of the bronchoscopy exam, an average of 30 min |
| Lidocaine dosage | Total lidocaine doses dispensed during the bronchoscopic procedure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chao-Chi Ho, MD, PhD | National Taiwan University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Taipei | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23860341 | Background | Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, Mandal S, Martin J, Mills J, Navani N, Rahman NM, Wrightson JM, Munavvar M; British Thoracic Society Bronchoscopy Guideline Group. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax. 2013 Aug;68 Suppl 1:i1-i44. doi: 10.1136/thoraxjnl-2013-203618. No abstract available. | |
| 32023078 |
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| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
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Group S patients will receive topical lidocaine anesthesia via the spray nozzle by the spray as-you-go technique during flexible bronchoscopy. Group C patients will receive topical lidocaine anesthesia with the conventional method by the spray as-you-go technique during flexible bronchoscopy.
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Patients will be randomly allocated into one of the two groups by the randomization module in REDCap. Patients and outcomes assessor will be blinded to their grouping.
| Through the duration of the bronchoscopy exam, an average of 30 min |
| Patient tolerance | Using a visual analogue scale from 0 to 10 to indicate patient tolerance of the bronchoscopy | Through the duration of the bronchoscopy exam, an average of 30 min |
| Patient satisfaction | Using a visual analogue scale from 0 to 10 to indicate patient satisfaction of the bronchoscopy | Through the duration of the bronchoscopy exam, an average of 30 min |
| Adverse events | Development of adverse events during the bronchoscopic procedure, such as bleeding and oxygen desaturation | Through the duration of the bronchoscopy exam, an average of 30 min |
| Background |
| Criner GJ, Eberhardt R, Fernandez-Bussy S, Gompelmann D, Maldonado F, Patel N, Shah PL, Slebos DJ, Valipour A, Wahidi MM, Weir M, Herth FJ. Interventional Bronchoscopy. Am J Respir Crit Care Med. 2020 Jul 1;202(1):29-50. doi: 10.1164/rccm.201907-1292SO. |
| 32445309 | Background | Mohan A, Madan K, Hadda V, Tiwari P, Mittal S, Guleria R, Khilnani GC, Luhadia SK, Solanki RN, Gupta KB, Swarnakar R, Gaur SN, Singhal P, Ayub II, Bansal S, Bista PR, Biswal SK, Dhungana A, Doddamani S, Dubey D, Garg A, Hussain T, Iyer H, Kavitha V, Kalai U, Kumar R, Mehta S, Nongpiur VN, Loganathan N, Sryma PB, Pangeni RP, Shrestha P, Singh J, Suri T, Agarwal S, Agarwal R, Aggarwal AN, Agrawal G, Arora SS, Thangakunam B, Behera D; Jayachandra; Chaudhry D, Chawla R, Chawla R, Chhajed P, Christopher DJ, Daga MK, Das RK, D'Souza G, Dhar R, Dhooria S, Ghoshal AG, Goel M, Gopal B, Goyal R, Gupta N, Jain NK, Jain N, Jindal A, Jindal SK, Kant S, Katiyar S, Katiyar SK, Koul PA, Kumar J, Kumar R, Lall A, Mehta R, Nath A, Pattabhiraman VR, Patel D, Prasad R, Samaria JK, Sehgal IS, Shah S, Sindhwani G, Singh S, Singh V, Singla R, Suri JC, Talwar D, Jayalakshmi TK, Rajagopal TP. Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations. Lung India. 2019 Jul;36(Supplement):S37-S89. doi: 10.4103/lungindia.lungindia_108_19. |
| 29487243 | Background | Madan K, Mohan A, Agarwal R, Hadda V, Khilnani GC, Guleria R. A survey of flexible bronchoscopy practices in India: The Indian bronchoscopy survey (2017). Lung India. 2018 Mar-Apr;35(2):98-107. doi: 10.4103/lungindia.lungindia_417_17. |
| 22045879 | Background | Wahidi MM, Jain P, Jantz M, Lee P, Mackensen GB, Barbour SY, Lamb C, Silvestri GA. American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. Chest. 2011 Nov;140(5):1342-1350. doi: 10.1378/chest.10-3361. |
| 35655299 | Background | Kim SY, Lee HJ, Lee JK, Park TY, Heo EY, Kim DK, Chung HS, Lee HW. Association between oxygen saturation level during bronchoscopy and post-bronchoscopy adverse events: a retrospective cohort study. Respir Res. 2022 Jun 2;23(1):144. doi: 10.1186/s12931-022-02063-0. |
| 30521615 | Background | Fujimoto K, Ishiwata T, Kasai H, Terada J, Shionoya Y, Ikari J, Kawata N, Tada Y, Tsushima K, Tatsumi K. Identification of factors during bronchoscopy that affect patient reluctance to undergo repeat examination: Questionnaire analysis after initial bronchoscopy. PLoS One. 2018 Dec 6;13(12):e0208495. doi: 10.1371/journal.pone.0208495. eCollection 2018. |
| 22074355 | Background | Ling IT, Piccolo F, Mulrennan SA, Phillips MJ. Posture influences patient cough rate, sedative requirement and comfort during bronchoscopy: An observational cohort study. Cough. 2011 Nov 10;7:9. doi: 10.1186/1745-9974-7-9. |
| 19703068 | Background | Antoniades N, Worsnop C. Topical lidocaine through the bronchoscope reduces cough rate during bronchoscopy. Respirology. 2009 Aug;14(6):873-6. doi: 10.1111/j.1440-1843.2009.01587.x. |
| 35441943 | Background | Cai Y, Chen L, Dong D, Ye M, Jin X, Liu F. The utility of a multi-orifice epidural catheter when using the "Spray-as-You-Go" technique for topical Airway Anesthesia during Flexible Bronchoscopy, a randomised trial. J Clin Monit Comput. 2023 Feb;37(1):55-62. doi: 10.1007/s10877-022-00856-8. Epub 2022 Apr 20. |
| 32883896 | Background | Venkatnarayan K, Devaraj U, Krishnaswamy UM, Ramachandran P, Thomas T, D'Souza G. Comparison of spray catheter with "spray-as-you-go" technique for airway anesthesia during flexible bronchoscopy - A randomized trial. Lung India. 2020 Sep-Oct;37(5):384-388. doi: 10.4103/lungindia.lungindia_528_19. |
| 28435314 | Background | Yildirim F, Ozkaya S, Yurdakul AS. Factors affecting patients' comfort during fiberoptic bronchoscopy and endobronchial ultrasound. J Pain Res. 2017 Mar 29;10:775-781. doi: 10.2147/JPR.S118047. eCollection 2017. |
| 33075060 | Background | Kobayashi F, Saraya T, Oda M, Sakuma S, Watanabe M, Takata S, Tamura M, Takakura H, Nakamoto K, Honda K, Ohkuma K, Mikura S, Inoue M, Hirata A, Kurokawa N, Shirai T, Aso K, Noda A, Miyaoka C, Yoshida Y, Ishikawa N, Morita K, Ieki E, Nakajima H, Ishii H, Takizawa H. Novel predictive factors for patient discomfort and severe cough during bronchoscopy: A prospective questionnaire analysis. PLoS One. 2020 Oct 19;15(10):e0240485. doi: 10.1371/journal.pone.0240485. eCollection 2020. |
| 12406852 | Background | Lechtzin N, Rubin HR, White P Jr, Jenckes M, Diette GB. Patient satisfaction with bronchoscopy. Am J Respir Crit Care Med. 2002 Nov 15;166(10):1326-31. doi: 10.1164/rccm.200203-231OC. Epub 2002 Jul 19. |