Murata Saori, Sasada Shinji, Usui Yusuke, Sakai Tetsuya, Kirita Keisuke, Ishioka Kota, Takahashi Saeko, Nakamura Morio
Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, Tokyo, JPN.
Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, JPN.
Cureus. 2021 Aug 16;13(8):e17231. doi: 10.7759/cureus.17231. eCollection 2021 Aug.
Background and objective Due to the outbreak of coronavirus disease 2019 (COVID-19), the Japanese Society of Respiratory Endoscopy recommended the omission of throat anesthesia using Jackson's spray prior to bronchoscopy for preventing aerosol generation. In this survey, we investigated the tolerability of patients toward the omission of anesthesia using Jackson's spray before bronchoscopy. Methods Group A patients received throat anesthesia with 5 mL of 4% lidocaine using Jackson's spray prior to bronchoscopy and were then administered pethidine hydrochloride and midazolam intravenously. Group B patients did not receive anesthesia using Jackson's spray before bronchoscopy. They were administered pethidine hydrochloride and midazolam and were then administered 8% lidocaine several times into the pharynx. A patient distress questionnaire, classified as a five-graded score, was administered to each group after bronchoscopy. Results Seventy patients participated in this study: 39 patients in Group A and 31 patients in Group B. There were no significant differences in their backgrounds. In the questionnaire survey, the distress caused by pre-examination anesthesia in Group A was significantly higher than in Group B (3.03 ± 1.25 vs. 1.23 ± 0.62; < 0.0001), and no significant differences were observed in the other questions during bronchoscopy. Conclusion This study demonstrates the tolerability of patients toward the omission of throat anesthesia using Jackson's spray prior to bronchoscopy, which is recommended for preventing infection, including COVID-19.
背景与目的 由于2019年冠状病毒病（COVID-19）的爆发，日本呼吸内镜学会建议在支气管镜检查前省略使用杰克逊喷雾进行咽喉麻醉，以防止产生气溶胶。在这项调查中，我们研究了患者对支气管镜检查前省略使用杰克逊喷雾麻醉的耐受性。方法 A组患者在支气管镜检查前使用杰克逊喷雾用5 mL 4%利多卡因进行咽喉麻醉，然后静脉注射盐酸哌替啶和咪达唑仑。B组患者在支气管镜检查前未使用杰克逊喷雾进行麻醉。他们先接受盐酸哌替啶和咪达唑仑，然后多次向咽部注入8%利多卡因。支气管镜检查后，对每组患者进行一份分为五级评分的患者痛苦问卷调查。结果 70名患者参与了本研究：A组39例，B组31例。他们的背景无显著差异。在问卷调查中，A组检查前麻醉引起的痛苦明显高于B组（3.03±1.25 vs. 1.23±0.62；<0.0001），支气管镜检查期间的其他问题上未观察到显著差异。结论 本研究证明了患者对支气管镜检查前省略使用杰克逊喷雾进行咽喉麻醉的耐受性，为预防包括COVID-19在内的感染，推荐采用这种方法。
