Participants received:

1. Standard sedation with midazolam (0.01 mg/kg IV);

2. 2 mL of 4% lignocaine spray in the oropharynx before bronchoscopy;

3. Additional 2% lignocaine spray (3 mg/kg):

   • 2-4 mL sprayed over vocal cords via bronchoscope working channel
   • Remaining dose as single bolus into larynx/trachea

Participants received:

1. Standard sedation with midazolam (0.01 mg/kg IV);

2. 2 mL of 4% lignocaine spray in the oropharynx before bronchoscopy;

3. 2% lignocaine spray (3 mg/kg) during procedure:

   • Initial 2-4 mL sprayed over vocal cords
   • Additional doses in mainstem bronchi during scope advancement

Administration of 2 mL of 4% lignocaine spray in the oropharynx before the fiberoptic bronchoscopy procedure, followed by additional 2% lignocaine spray according to body weight (3 mg/kg)

This composite outcome evaluates three distinct parameters:

1. Cough severity measured by the Visual Analog Scale (100-mm scale where 0 mm indicates no cough and 100 mm indicates worst possible cough, with higher scores representing worse severity);
2. Pain perception assessed via the Faces Pain Rating Scale (11-point scale from 0 [no pain] to 10 [worst imaginable pain], where higher scores indicate worse pain); and
3. Operator comfort rated on a 4-point Likert scale (1 = Not comfortable to 4 = Very comfortable, with higher scores reflecting better comfort).

All measures will be analyzed separately to compare PPL and SAYG techniques

Cough severity measured using 100-mm Visual Analog Scale where 0 mm = no cough and 100 mm = worst cough imaginable. Higher scores indicate worse cough severity.

Pain intensity measured using Faces Pain Rating Scale (0-10) where 0 = no pain and 10 = worst pain possible. Higher scores indicate worse pain.

Operator comfort assessed via 4-point Likert scale where 1 = Not comfortable, 2 = Slightly uncomfortable, 3 = Comfortable, and 4 = Very comfortable. Higher scores indicate better comfort.

Comparison of procedure duration between PPL and SAYG airway anesthesia methods, measured in minutes from scope insertion to withdrawal.

This study will compare the effectiveness of pre-procedure lignocaine spray (PPL) and spray-as-you-go (SAYG) techniques in suppressing cough, measured by the Visual Analog Scale (VAS). The VAS is a 100-mm scale where 0 = no cough and 100 = worst cough, with higher scores indicating worse outcomes.