Clinical evaluation of the Trachospray device for upper airway anaesthesia

During bronchoscopy, awake fibreoptic tracheal intubation and other instrumentations of the airway, it is important to provide comfortable, effective fast topical anaesthesia upper airway. Different methods anaesthetising airway have been described, but obtaining complete remains a challenge. We designed soft mist inhaler device suitable for ‘Trachospray’ (Medspray Anesthesia BV, Enschede, The Netherlands) (Fig. 1), featuring patented spray nozzle unit produce specific droplet size. An interventional study was evaluate clinical performance Trachospray in healthy volunteers. Performance determined by degree evaluation its use comfort level subjects while performing laryngobronchoscopy. Twenty volunteers (9 men, 11 women, mean (SD) age 23 (0.5) years, weight 72 (2) kg, height 179 cm) inhaled through Trachospray, which placed mouth. Using syringe connected 2 × ml lidocaine 4% sprayed into during normal inspiration as only means anaesthesia. Bronchoscopy using bronchoscope (Ambu aScope, Ambu, Ballerup, Denmark) performed an anaesthetist (JB), aiming position distal tip trachea, after intravenous administration 2.5 mg midazolam 5 ug sufentanil. bronchoscopy documented video used analysis afterwards. After reviewing recorded videos, results can be summarised follows: Group 1: no response, easily introduced trachea (n = 14, 70%); 2: response passing vocal cords, short cough occurred when wall touched 2, 10%); 3: cords were passed. coughing stopped appeared 1, 5%). 4: passage cords. When touched, they close or gag reflex occurred. Passage not immediately possible 3, 15%). Mean spraying time 239 (6) s, duration 74 s. Volunteers reported good very with high numerical rating score 9, (where 0 10 comfortable) pain fear. non-invasive technique, contrast commonly invasive techniques such trans-tracheal injection superior laryngeal nerve blocks, method applying anaesthesia, whereas usually two more are chosen, example, 10% oropharynx, tonsillar pillars base tongue, combined 2% above, at below via epidural catheter [1] plus, if needed, spray-as-you-go technique. In conclusion, this demonstrated that provided fast, adequate allows comfortable flexible most More research warranted order determine optimal dose local larger numbers patients. reviewed approved medical ethical commission Radboud UMC, Nijmegen, Netherlands (NL 70682.091.19; Trial Register: NL8187). GvG, MvB JB patent pending Trachospray. No competing interests declared.