ORIGINAL ARTICLE
Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 128-137

Comparison between bronchoscopy under general anesthesia using laryngeal mask airway and local anesthesia with conscious sedation: a patient-centered and operator-centered outcome


1 Department of Chest Medicine, Ain Shams University, Cairo, Egypt
2 Department of Anesthesia, Mostafa Kamel Military Hospital, Alexandria, Egypt
3 Department of Anesthesia, Ain Shams University, Cairo, Egypt

Correspondence Address:
Hesham Raafat
Mouwasat Hospital, Dammam 41311
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.145707

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Background and objectives With the evolution of complex bronchoscopic procedures, search for procedures that were less painful to patients and easier for the operators to perform commenced. Conscious sedation partially achieved this target. We aimed to compare conscious sedation with general anesthesia (GA) in achieving a safer and more painless procedure. Patients and methods Eighty patients were included: 36 (45%) were subjected to local anesthesia (LA) with midazolam and 44 (55%) to GA through laryngeal mask airway. Patients responded to a visual analogue scale (VAS) for cough, choking, dyspnea, nausea, vomiting, nasal symptoms, chest pain, and anxiety during bronchoscopy. Postbronchoscopy VAS included cough, fever, dyspnea, nausea, vomiting, nasal symptoms, and hemoptysis. Lastly, VAS for the tolerability of bronchoscopy and acceptance to repeat the procedure were answered. Operator VAS included cough, desaturations, easiness of the procedure, and success. Bronchoscopy, recovery times, the number of biopsies, and cost were recorded. Results GA was significantly less symptomatic during bronchoscopy than LA (P = 0.0001). Nasal symptoms were more in LA after bronchoscopy (P = 0.003). Anxiety was more in LA (P = 0.014). The GA group found bronchoscopy to be more tolerable (P = 0.0001), and accepted to repeat the procedure (P = 0.001). The operator found that GA was associated with significantly less cough and desaturations, and was easier to perform (P = 0.0001). The duration of the procedure, the recovery time, the number of biopsies, and the cost were significantly higher in GA (P = 0.0001). Safety was equal in both groups. Conclusion GA serves as a more peaceful procedure for the patient and the operator than LA, but at the expense of recovery time and cost. Egypt J Broncho 2014 8:128-137


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