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.

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 hours 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.