19 KB55 KB17 KB192920262001Debeljak, AndrejEržen, DamijanKecelj, PeterOsolnik, KatarinaTriller, Nadjaštevilka:10letnik:70str. 543-545ISSN:1318-0347COBISSID:14052313URN:URN:NBN:SI:doc-YQPUKK4UslSlovensko zdravniško društvoZdravniški vestnikAnestezija lokalnaAnesthesia, localAtropinAtropinebolezni dihalBronchoscopyBronhoskopijadiagnostikadihalaInstrumentationLidocaineLidokainlokalna anestezijaMethodsBronhoskopija z upogljivim bronhoskopom| Flexible bronchoscopy| primerjava anestezije skozi delovni kanal bronhoskopa s transkrikoidno lokalno anestezijo z atropinom ali brez v premedikaciji - randomizirana študija| ranscricoid versus bronhoscopic administration of lidocaine for topical anaesthesia with or without atropine as premedication - a randomized study|Background. We were interested to study the effect of different ways of administering topical lidocaine and the possible benefit of using atropine as premedication for flexible bronchoscopy. Patients and methods. 105 patients were randomised into four groups. Lidocaine was administered either through the bronchoscope orby transcricoid injection. The use of atropine premedication was also randomised. The duration of bronchoscopy sessions, amount of lidocaine used, symptomes and signs such as coughing, heart rate andoxygene saturation were documented. Patients and medical staff graded theirperceptions of the procedure using a four-grade severity scale. Results. The duration of the bronchoscopy was not significantly prolonged in the group with bronchoscopic lidocaine administration compared to the transcricoid group(p - 0.6). The patients with bronchoscopic lidocaine administration required significantly more additional lidocaine than in the transcricoid group (p = 0.03). No significant difference was found in patients who receivedatropine and those without it. Severe coughing recorded by bronchoscopists and nurses was significantly more frequent in patients withoutatropine premedication (p = 0.006) but patient did not experience the bronchoscopy to be more unpleasant without atropine. Conclusions. Patients tolerated both variants of topical anaesthesia equally well but less amount ofadditional lidocaine was used by transcricoid administration. The use of atropine was of no benefit, but resulted in more tachycardia eventsIzhodišča. Zanimalo nas je, kateri način lokalne anestezije z lidokainom je uspešnejši in ali je atropin kot premedikacija pred bronhoskopijo z upogljivimbronhoskopom res potreben. Bolniki in metode. V raziskavo smo vključili 105 bolnikov, ki smo jih randomizirali v štiri skupine. Prvi skupinibolnikov smo vbrizgali lidokain v sapnik skozi krikotiroidno membrano, drugi skozi delovni kanal bronhoskopa. Bolniki so bili randomizirani tudi v skupino, ki je prejela atropin, in v skupino, ki atropina ni prejela. Pri vsehsmo spremljali vsebnost kisika v krvi, frekvenco pulza, intenzivnost kašlja ter trajanje bronhoskopije. Bolniki in zdravstveno osebje v bronhoskopiji so ocenili težavnost bronhoskopije po štiristopenjski lestvici. Rezultati. Trajanje bronhoskopije je bilo nekoliko daljše v skupini; ki je prejela anestezijo skozi delovni kanal bronhoskopa (p-0,6). Ta skupina bolnikov je potrebovala tudi signifikantno več dodatnega lidokaina (p=0,03) kot skupina, ki smo jo anestezirali skozi krikotiroidno membrano. Razlike v porabi dodatnega lidokaina med skupinama z atropinom ali brez nismo opazili. Po oceni medicinskega osebja so bolniki, ki niso prejeli atropina, značilno bolj kašljali (p=0, 006). Bolniki te razlike niso potrdili. Zaključki. Bolnikiprenašajo oba načina anestezije enako dobro. Pri anesteziji skozi krikotiroidno membrano smo med bronhoskopijo porabili manj dodatnega lidokaina. Ob uporabi atropina smo opazili več tahikardijTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo