Role of Nebulised Lignocaine With Midazolam In Flexible Bronchoscopy in Reducing Patient Cough , Discomfort & Study the Side Effects of Nebulised Lignocaine in Patients Undergoing Fibro Optic Bronchoscopy Scope

Topical anesthesia for flexible bronchoscopy can be achieved in several ways like administration of an anesthetic agents by injecting through cricothyroid membrane,by giving drug lignocaine through Nebulization, 3}administering the drug through oral spray. Nebulization of lidocaine can achieve very satisfying anesthesia comparable to oral spraying with significant low plasma levels of the drug. Nebulization of lidocaine with midazolam gives good results than using only lidocaine without sedation. Nebulization of lidocaine gives effective analgesia & the dose of conscious sedation is significantly reduced. So we studied the effect of nebulized lignocaine with midazolam as sedation in 60 patients needing bronchoscopy and compared them to 50 patients who underwent fibrooptic bronchoscopy with oral spray of lignocaine and midazolam as sedation. This is a study of 110 patients undergoing bronchoscopy were subjected to conscious sedation& local anaesthesia in Govt general hospital Osmania medical college for a period of two years. Patients were in the age group of 25 to 75 years. After obtaining consent, 60study cases were given nebulization. With lidocaine & sedation with midazolam. Control group had bronchoscopy with oral spray of drug lignocaine and midazolam given for sedation .All patients had Intravenous lines, pulse oximetry monitoring of saturations, serial recordings of their blood pressure, pulse, respiratory rate were noted. All patients received supplemental oxygen through oral mask at the rate of 1-2 liters per minute. In study group, patients had 4 ml of lidocaine diluted in 4 ml of normal saline by nebulization for 15 minutes, beforebronchoscopy,control patients had lidocaineoral spraying before bronchoscopy. After the procedure patients perception of discomfort ,their severity of cough ,were analyzed ,discomfort status was perceived by administration of visual analog scale, heart rate, breathing patterns, blood pressure and continuous pulse oximetry readings in both groups are compared. Patients undergoing bronchoscopy after nebulization with lignocaine have less intensity of cough, they tolerate the procedure better than placebo group, experience less discomfort during bronchoscopy. Oxygen saturation is well maintained in study group. These patients needed less dose of midazolam for conscious sedation. Statistical analysis was performed by calculating mean, P Value. Standard Deviation , Anova For Cough Score By Patients & Physicians, Anova For Discomfort Score ,Anova For Total Lignocaine Dose in both groups. Nebulised lignocaine with midazolam sedation before bronchoscopy is safe .These patients undergo bronchoscopy procedure better than control group. They have less cough .stable vital parameters, less discomfort during and after procedure.