局部利多卡因麻醉提高全身麻醉下超声引导下经支气管针吸术后患者满意度的有效性和安全性：一项随机对照试验。

IF 3.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-21 DOI:10.1016/j.accpm.2025.101495

Sen Zhang , Wannan Chen , Jian Wang , Changhong Miao , Hao Fang , Chao Liang

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引用次数: 0

摘要

背景：支气管超声引导下经支气管针吸术（EBUS-TBNA）是胸外科医生和肺科医生常用的一种有效技术。本研究评估了局部利多卡因麻醉在支气管镜检查期间提高全麻下择期EBUS-TBNA患者满意度的安全性和有效性。方法：在大学附属教学医院进行单中心前瞻性、随机、双盲临床试验。196例患者在全麻下行选择性EBUS-TBNA。患者被随机分配接受1%利多卡因(T)或生理盐水(C)的表面麻醉。主要结果是喉罩取下后立即咳嗽频率。次要结局包括咳嗽频率和强度（视觉模拟量表[VAS]）、生命体征变化、不良事件、术后肺部并发症和康复质量-15 （QoR-15）问卷调查。结果：共有196例患者接受了随机分组（91例）。结论：在EBUS-TBNA全麻下，1%利多卡因表面麻醉可显著降低术后咳嗽发生率，提高患者满意度。在全身麻醉下进行EBUS-TBNA的患者应常规给予表面麻醉。注册：中国临床试验注册中心；注册号：ChiCTR2300072386；URL: https://www.chictr.org.cn/showproj.html?proj=197032。

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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

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.

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

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.