Efficacy and safety of topical lignocaine anesthesia in improving patient satisfaction after endobronchial ultrasound–guided transbronchial needle aspiration under general anesthesia: A randomized controlled trial
Sen Zhang , Wannan Chen , Jian Wang , Changhong Miao , Hao Fang , Chao Liang
{"title":"Efficacy and safety of topical lignocaine anesthesia in improving patient satisfaction after endobronchial ultrasound–guided transbronchial needle aspiration under general anesthesia: A randomized controlled trial","authors":"Sen Zhang , Wannan Chen , Jian Wang , Changhong Miao , Hao Fang , Chao Liang","doi":"10.1016/j.accpm.2025.101495","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an effective technique used by thoracic surgeons and pulmonologists. This study evaluated the safety and efficacy of topical lignocaine anesthesia during bronchoscopy to improve the satisfaction of patients undergoing elective EBUS-TBNA under general anesthesia.</div></div><div><h3>Methods</h3><div>This was a single-center prospective randomized, double-blind clinical trial in University-affiliated teaching hospitals. A total of 196 patients underwent elective EBUS-TBNA under general anesthesia. Patients were randomly assigned to receive topical anesthesia with 1% lignocaine (T) or saline (C). The primary outcome was coughing frequency immediately after laryngeal mask removal. Secondary outcomes included coughing frequency and intensity (visual analog scale [VAS]), vital sign changes, adverse events, postoperative pulmonary complications, and the Quality of Recovery-15 (QoR-15) questionnaire.</div></div><div><h3>Results</h3><div>A total of 196 patients underwent randomization (91 in. T and 94 in C). Topical anesthesia with lignocaine significantly reduced the cough rate and VAS score immediately (<em>P</em> < 0.001 and < 0.001, respectively), 10 min (<em>P</em> < 0.001 and < 0.001), and 30 min (<em>P</em> = 0.005 and 0.001) after mask removal, and 2 h post-procedure (<em>P</em> = 0.003 and 0.006). No significant effect on vital signs was observed. The QoR-15 values 24 h after the procedure in group T were higher than those in group C (<em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>During EBUS-TBNA under general anesthesia, 1% lignocaine for topical anesthesia significantly decreased the incidence of postoperative coughing and increased patient satisfaction. Topical anesthesia should be routinely administered to patients undergoing EBUS-TBNA under general anesthesia.</div></div><div><h3>Registration</h3><div>Chinese Clinical Trial Registry; Registration number: ChiCTR2300072386; URL: <span><span>https://www.chictr.org.cn/showproj.html?proj=197032</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101495"},"PeriodicalIF":3.7000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia Critical Care & Pain Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S235255682500027X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an effective technique used by thoracic surgeons and pulmonologists. This study evaluated the safety and efficacy of topical lignocaine anesthesia during bronchoscopy to improve the satisfaction of patients undergoing elective EBUS-TBNA under general anesthesia.
Methods
This was a single-center prospective randomized, double-blind clinical trial in University-affiliated teaching hospitals. A total of 196 patients underwent elective EBUS-TBNA under general anesthesia. Patients were randomly assigned to receive topical anesthesia with 1% lignocaine (T) or saline (C). The primary outcome was coughing frequency immediately after laryngeal mask removal. Secondary outcomes included coughing frequency and intensity (visual analog scale [VAS]), vital sign changes, adverse events, postoperative pulmonary complications, and the Quality of Recovery-15 (QoR-15) questionnaire.
Results
A total of 196 patients underwent randomization (91 in. T and 94 in C). Topical anesthesia with lignocaine significantly reduced the cough rate and VAS score immediately (P < 0.001 and < 0.001, respectively), 10 min (P < 0.001 and < 0.001), and 30 min (P = 0.005 and 0.001) after mask removal, and 2 h post-procedure (P = 0.003 and 0.006). No significant effect on vital signs was observed. The QoR-15 values 24 h after the procedure in group T were higher than those in group C (P < 0.001).
Conclusions
During EBUS-TBNA under general anesthesia, 1% lignocaine for topical anesthesia significantly decreased the incidence of postoperative coughing and increased patient satisfaction. Topical anesthesia should be routinely administered to patients undergoing EBUS-TBNA under general anesthesia.
Registration
Chinese Clinical Trial Registry; Registration number: ChiCTR2300072386; URL: https://www.chictr.org.cn/showproj.html?proj=197032.
期刊介绍:
Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.