前瞻性队列研究局部麻醉与全身麻醉用于纤维支气管镜检查。

Prospective cohort study of topical versus general anaesthesia for flexible bronchoscopy.

机构信息

Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

Department of Endoscopy, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

Postgrad Med J. 2023 May 22;99(1170):313-317. doi: 10.1136/postgradmedj-2021-141359.

DOI:10.1136/postgradmedj-2021-141359

PMID:37227971

Abstract

BACKGROUND

Topical anaesthesia (TA) and general anaesthesia (GA) are performed for flexible bronchoscopy (FB) worldwide. However, few studies have compared the two anaesthesia methods in terms of perioperative discomforts.

METHODS

648 patients undergoing FB were recruited in Shanghai Pulmonary Hospital, a specialised medical centre in China, from January 2019 to December 2019. The patients underwent FB under TA or GA. The TA group received 1% lidocaine by nasal route, and the GA group received total intravenous anaesthesia. The level of perioperative discomfort and patient satisfaction were assessed. The investigators were blind to the group allocation.

RESULTS

Finally, 239 patients received TA and 182 patients received GA. The basic demographic properties were comparable between two groups. There were no significant differences in terms of sore throat, 61.5% in TA group vs 57.1% in GA group. However, there was a significant difference in terms of postoperative nausea and vomiting (34.3% in TA group vs 56.6% in GA group), and dizziness (37.7% in TA group vs 78% in GA group). There was a significant difference in terms of total complication scores (17.2 ± 5.1 in TA group vs 7.7 ± 4.3 in GA group) and satisfaction degree of patients (2.6 ± 1.1 in TA group vs 4.3 ± 0.8 in GA group).

CONCLUSIONS

Compared with TA, GA significantly reduced the total complication scores of perioperative discomforts and improved the satisfaction score of patients for FB.

TRIAL REGISTRATION NUMBER

This clinical trial was registered with www.chictr.org.cn (ChiCTR1800019971).

摘要

背景

全球范围内，经鼻给予 1%利多卡因行局部麻醉（TA）或全身麻醉（GA）用于行软性支气管镜检查（FB）。然而，很少有研究比较两种麻醉方法在围手术期不适方面的差异。

方法

2019 年 1 月至 2019 年 12 月，上海肺科医院招募了 648 例行 FB 的患者，这些患者均来自中国的一个专业医疗中心。这些患者分别接受 TA 或 GA 麻醉。TA 组患者经鼻给予 1%利多卡因，GA 组患者接受全凭静脉麻醉。评估围手术期不适的程度和患者的满意度。研究者对分组情况不知情。

结果

最终，239 例患者接受 TA，182 例患者接受 GA。两组患者的基本人口统计学特征相似。在咽痛方面，TA 组为 61.5%，GA 组为 57.1%，两组间无显著差异。但在术后恶心呕吐方面，TA 组为 34.3%，GA 组为 56.6%，两组间有显著差异；在头晕方面，TA 组为 37.7%，GA 组为 78%，两组间也有显著差异。在总并发症评分方面，TA 组为 17.2±5.1，GA 组为 7.7±4.3，两组间有显著差异；在患者满意度方面，TA 组为 2.6±1.1，GA 组为 4.3±0.8，两组间也有显著差异。